Gastropathies in children induced by NSAIDs: a case of ulcerative bleeding in a child taking ketorolac

Background. The term "NSAID-induced gastropathy" was proposed in 1986 to distinguish specific damage to the gastric mucosa caused by prolonged use of nonsteroidal anti-inflammatory drugs from classic peptic ulcer disease. The widespread use of nonsteroidal antiinflammatory drugs (NSAIDs), on the one hand, and the need for their prolonged or continuous use, on the other, contribute to the spread of NSAID-induced gastropathy. Currently, there is a trend toward a 2-3-fold increase in the consumption of nonsteroidal antiinflammatory drugs every 10 years. Each year, more than 300 million people take nonsteroidal anti-inflammatory drugs, with only 1/3 of them doing so as prescribed by a doctor.

Objective. The article is devoted to one of the urgent problems of pediatric gastroenterology – peptic ulcer of the stomach and duodenum and complications in the form of gastrointestinal bleeding.

Results. Data on the pathogenesis, diagnosis, and treatment of ulcerative bleeding in children are presented. It is noted that the diagnosis of ulcerative bleeding is based on a combination of clinical manifestations, laboratory and instrumental studies. The article provides information on the prevalence, significant factors in the development of the disease, and research data showing a link between taking medications, mainly nonsteroidal anti-inflammatory drugs, and the risk of NSAID-induced gastropathy and ulcerative bleeding. The article shows how nonsteroidal anti-inflammatory drugs affect the course of peptic ulcer of the stomach and duodenum. Data on the possibility of ulcerative bleeding while taking nonsteroidal anti-inflammatory drugs are presented. The authors' own observations are presented as a demonstration. A clinical example describes a case of ulcerative bleeding in a teenager taking nonsteroidal anti-inflammatory drugs uncontrollably.

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