Non-steroidal antiinflammatory drugs (NSAIDs) are responsible for dyspeptic symptoms in more than 50% of patients. Symptomatic ulcers and ulcer complications occur in less than 5%. In order to avoid these complications during prolonged treatment, the lowest possible NSAID dose should be chosen. Furthermore, NSAIDs can often be replaced by paracetamol. Prophylaxis of NSAIDs and ulcers with misoprostol is only indicated in a small risk group of patients (eg: advanced age, history of ulcer and for gastrointestinal bleeding, concurrent corticosteroid treatment and significant comorbidity) and only if NSAIDs are given for several months. NSAIDs-induced ulcers should be treated with omeprazole in a dose of 20-40 mg daily.
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