Nonsteroidal anti-inflammatory drugs, arthritis, and gastrointestinal bleeding in elderly in-patients.

In a study of 531 consecutive admissions to an acute geriatric admitting unit in England in a four-month period, 33 cases of upper gastro-intestinal (UGI) bleeding were diagnosed. There was a close relationship between UGI bleeding and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and it is argued that this is a causal link. In view of the dangers of NSAID ingestion by elderly patients, many of whom are using them for analgesic rather than anti-inflammatory reasons, it is suggested that simple analgesics such as paracetamol should be used for maintenance therapy of osteoarthritis in the elderly, with NSAIDs being reserved for treatment of true arthritis in selected patients.