[Esophageal Complications of Non Steroidal Antiinflammatory Drugs]

The effect of non steroidal anti-inflammatory drugs (NSAIDs) on esophageal mucosa is not well known. NSAIDs do not provoke gastro-esophageal reflux disease in healthy subjects but can worsen a preexistant non symptomatic reflux. Mechanism of action is not determined; NSAIDs do not modify the motility of lower esophagus sphincter or of esophageal body. A significant increase of symptoms of GERD (hearthburn and acid regurgitation) is observed in patients treated with NSAIDs. Relative risk of GERD symptoms with NSAIDs is about 2. Erosive esophagitis is common in elderly patients taking NSAIDs but it is not proven that an increased risk of esophagitis exists with NSAID therapy. Case-control studies favored an association between NSAIDs consumption and benign esophageal stricture. NSAIDs can provoke a pill-induced esophagitis, specially if the drugs are absorbed without water and in case of preexistant acid reflux.