Which adverse effect is most concerning for patients taking NSAIDs?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to manage pain and inflammation, but they carry a risk of significant gastrointestinal adverse effects, with gastrointestinal ulcers being one of the most serious. NSAIDs inhibit the production of prostaglandins, which play a crucial role in maintaining the protective lining of the stomach and intestines. When prostaglandin levels decrease due to NSAID use, the mucosal barrier is compromised, leading to an increased risk of irritation, erosion, and ulceration in the gastrointestinal tract.

Gastrointestinal ulcers can result in serious outcomes, including bleeding, perforation of the gastrointestinal lining, and the need for surgical intervention. This risk is particularly concerning in older adults or in those with a history of gastrointestinal issues. While skin rash, constipation, and chest pain may occur as side effects, they are typically less severe and pose less immediate risk to patient safety compared to the potential for gastrointestinal ulcers when taking NSAIDs.