The major side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Some 10%-50% of patients are unable to tolerate NSAID treatment because of side effects, including abdominal pain, diarrhea, and upset stomach. Approximately 15% of patients on long-term NSAID treatment develop a peptic ulcer (ulceration of the stomach and duodenum). Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications such as bleeding or perforation of the stomach.
The annual risk of serious complications is 1%-4% with chronic NSAID treatment. The risk of complications is higher in elderly patients, in those with rheumatoid arthritis, patients taking blood-thinning medications (anticoagulants such as warfarin (Coumadin) and heparin)) or cortisone-containing medications (for example, prednisone), and patients with heart disease or a prior history of bleeding ulcers.
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