Is there a relationship between the use of analgesics and non-steroidal anti-inflammatory drugs and acute upper gastrointestinal bleeding? A Finnish case-control prospective study

Background: Our object was to study the role of non-steroidal anti-inflammatory drugs (NSAIDs) as a risk factor in upper gastrointestinal bleeding. Methods: Forty-eight patients with acute bleeding due to esophagitis, gastric or duodenal ulcer, or erosions and 156 age- and sex-matched control patients from the same emergency units were interviewed about the history of ulcer disease, smoking and alcohol habits, and use of analgesics or NSAIDs. Results Twenty-four patients (50%) and 90 controls (57.6%) had no previous upper abdominal symptoms (NS). There were more heavy smokers among patients (n = 9; 18.8%) than controls (n = 7; 4.5%) (p < 0.01). Five patients (10.4%) and one control (0.6%) had taken more than 20 drinks during the week before admission (p < 0.001). Twenty-nine patients (62.5%) and 81 controls (51.9%) had used some analgesics during the week before admission (NS). There was no difference in the duration of the use of analgesics in the patients and controls. Conclusion: The results do not support the concept that NSAIDs are a major factor associated with serious upper gastrointestinal bleeding.