Ulcer stopper

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MEDICAL-CARE NEWS

First-ever prevention for NSAID-caused ulcers

Nonsteroidal anti-inflammatory drugs (NSAIDs) often become dependable friends for arthritis sufferers and other people who experience daily pain. These friends have one ugly trait though--too much of them can lead to ulcers.

Several years ago, the FDA approved the first-ever drug that actually prevents these ulcers from occurring. In a recent study, the drug--called misoprostol--proved 10 times better than previous standard treatment aimed at reducing these ulcers.

When 131 patients taking nonsteroidal inflammatories (ibuprofen, piroxicam or naproxen) for osteoarthritis also took sucralfate, a commonly prescribed drug used to combat ulcers, 21 people still developed them after three months of treatment. But in a group of 128 adults who took misoprostol instead of sucralfate, only two had ulcers (Gastroenterology, May 1990).

"This drug is unique in that it doesn't treat ulcers, it prevents them," says Naurang Agrawal, M.D., professor of medicine at the Tulane University School of Medicine. "It works by reducing the amount of acid your stomach produces." The drug has recently become the standard choice for prevention of gastric ulcers from NSAID use.

"The side effects of misoprostol are diarrhea and abdominal cramps, which can be reduced if the drug is taken on a full stomach," says Dr. Agrawal. In rare cases, the diarrhea can be serious enough to warrant discontinuing treatment. Because of this side effect, misoprostol should be used with extreme caution in patients with known inflammatory bowel disease.

"Gastric ulcers occur in about 20 to 25 percent of people taking NSAIDs every day," he says. "If you're taking more than four pills every day, you should talk to your doctor about preventive treatment for ulcers."

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By Greg Gutfeld

With Maureen Sangiorgio; Linda Rao

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