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Is prescription of Proton Pump Inhibitor (PPI) necessary whenever NSAIDs are prescribed?

Asked by Anonymous 

The coprescription of PPIs and NSAIDs has benefited patients at risk of upper-GI ulcers and bleeding. However, this common prescribing practice may have potentially deleterious effects on small-bowel mucosa, possibly through a combination of gut dysbiosis and increased intestinal permeability. Accumulating data from several recent large-scale human studies suggest that the use of a lower-acidity COX2 inhibitor may be a suitable strategy for patients who are at high risk of both upper- and lower-GI adverse events.

Gwee KA, Goh V, Lima G, Setia S. Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: risks versus benefits. J Pain Res. 2018 Feb 14;11:361-374. doi: 10.2147/JPR.S156938. PMID: 29491719; PMCID: PMC5817415.

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