What effect do non-steroidal anti-inflammatory drugs (NSAIDs) have on the gastrointestinal tract?

Non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of developing peptic ulcers due to their mechanism of action. NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which are crucial for the production of prostaglandins. Prostaglandins have a protective role in the gastrointestinal tract; they help maintain the gastric mucosal barrier and stimulate the production of mucus and bicarbonate, which neutralizes stomach acid.

When NSAIDs inhibit the production of these protective prostaglandins, the gastric mucosa becomes more susceptible to damage from gastric acid. This deficiency in mucosal protection can lead to inflammation, erosion, and ultimately the formation of peptic ulcers, especially in individuals who take NSAIDs regularly or at higher doses.

In contrast, while NSAIDs reduce inflammation, they do not decrease gastric acidity; in fact, they can exacerbate conditions related to high acidity due to the inhibited protective mechanisms. They also do not improve digestion but primarily serve to relieve pain and inflammation. Therefore, the increased risk of developing peptic ulcers is a significant consideration when prescribing or overusing NSAIDs.