Table of Contents
Compared to NSAIDs, COX-2 inhibitors may pose less risk for uncomplicated ulcers, but these medications do not seem to reduce the risk of more serious events, such as bleeding or perforation.
Contributing Factors. Certain factors may increase the risk for ulcers in NSAID users:
- Being age 65 or older
- Having a history of peptic ulcers or upper gastrointestinal bleeding
- Having other serious ailments, such as congestive heart failure
- Using other medications, such as the anticoagulant warfarin (Coumadin), corticosteroids, or the osteoporosis drug alendronate (Fosamax)
- Abusing alcohol
- Being infected with H. pylori
Other Risk Factors for Ulcers from H. pylori or NSAIDs
Stress and Psychological Factors. Although stress is no longer considered a cause of ulcers, some studies still suggest that stress may predispose a person to ulcers or prevent existing ulcers from healing.
Smoking. Smoking increases acid secretion, reduces prostaglandin and bicarbonate production, and decreases blood flow. However, the results of studies on the actual effect of smoking on ulcers are mixed. Some evidence suggests that smoking delays the healing of gastric and duodenal ulcers. Other studies have found no increased risk for ulcers in smokers.
Review Date: 07/18/2011
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital. Also reviewed by David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
