Gastrointestinal Adverse Reactions from Ibuprofen

Gastrointestinal ulceration, when associated with perforation and bleeding, is amongst the most serious but rarely life-threatening conditions associated with use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs vary considerably in their propensity to cause adverse reactions in different regions of the gastrointestinal tract (GIT). This chapter reviews the current situation concerning the occurrence and importance of NSAID-associated gastric ulcer disease and NSAID-enteropathy, including a large amount of clinicoepidemiological data on the relative effects of ibuprofen compared with other NSAIDs or placebo that has been published during the past 40 years. The methods for determining and comparing GI safety of ibuprofen are also reviewed. A range of techniques have been employed to assess GI injury from NSAIDs in humans. Two principal techniques that have had widest acceptance include endoscopy and radiochromium faecal blood loss.