Gastrolesive drugs - Drugs that cause gastritis and peptic ulcer

Gastrolesive drugs have the potential to generate inflammatory processes on the gastric mucosa (gastritis), leading to real erosions and acute ulcerations. If used by people already suffering from these diseases, gastrolesive drugs increase the risk of bleeding and perforations from peptic ulcers, slowing healing and reducing the therapeutic efficacy of gastroprotective drugs.

All patients suffering from gastritis or peptic ulcer should therefore avoid taking gastrolesive drugs; however, even in the healthy population, particular prudence is required in the continued use of these drugs, possibly using buffered forms and alternative medicines (eg selective COX-2 inhibitors instead of traditional NSAIDs), or combining gastroprotectors such as Misoprostol, Omeprazole and Lansoprazole . In subjects treated with gastrolesive drugs it would also be advisable to reduce alcohol consumption and cigarette smoking, as they are important risk factors for gastritis and peptic ulcer, and enhancers of the gastrolesivity of these drugs; in this regard, see the rules for proper food hygiene during gastritis.

Major gastrolesive drugs:

• Non-steroidal anti-inflammatory drugs (NSAIDs), which also include the famous aspirin (acetylsalicylic acid): they are the gastrolesive drugs par excellence, given the large presence in numerous over-the-counter (OTC) medicines. Below are some of them in descending order of gastric sensitivity: Ketorolac (the most gastrolesive), Piroxicam, Indomethacin, Ketoprofen, Naproxen, Diflunisal, Sulindac, Nimesulide, Ibuprofen, Diclofenac and Paracetamol (the least gastric acid but high in the liver) ). The combination of more NSAIDs, except for direct medical prescription, is contraindicated since it increases the risk of gastric laxity.
• Steroidal anti-inflammatory drugs (cortisone):
• Anticoagulant drugs (low-dose acetylsalicylic acid, heparin, warfarin) increase the risk of bleeding ulcers already in place; before the use of these drugs the subjective risk based on age, concomitant diseases, history of peptic ulcer, previous episodes of gastrointestinal haemorrhage, concomitant use of NSAIDs or aspirin, and duration and intensity of anticoagulant treatment should be evaluated.
• Antiblastic (antitumor) drugs.
• Antidepressant serotonin reuptake inhibitors (SSRIs), such as fluoxetine; enhance the gastrolesivity of NSAIDs.

Medicinal herbs that can increase the gastrolesivity of the drugs mentioned, in particular NSAIDs: angelica, dandelion, bitter orange peel, anise, star anise, devil's claw, Roman chamomile, cinnamon, artichoke, centaurea minor, ivy, gentian, guaiac, clover fibrin.