Which condition may worsen with the use of NSAIDs?

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) can significantly worsen the condition of active gastrointestinal ulcers. NSAIDs work by inhibiting the cyclooxygenase (COX) enzymes necessary for the synthesis of prostaglandins, which play a critical role in maintaining the protective mucosal layer of the gastrointestinal tract. Prostaglandins help regulate gastric acid secretion, promote mucus production, and maintain mucosal blood flow.

When NSAIDs are used in a patient with existing gastric or duodenal ulcers, the reduction of these protective factors can lead to worsened ulceration, increased risk of bleeding, and delayed healing. This is particularly concerning for patients who already have compromised mucosal integrity due to the presence of ulcers. Therefore, caution is advised when prescribing NSAIDs to individuals with a history of GI ulcers or similar conditions.