Gastrointestinal Toxicity of Nonsteroidal Antiinflammatory Drugs

One hundred years have passed since Felix Hoffman, working at Bayer Industries, reported the successful synthesis of acetylsalicylic acid as the first nonsteroidal antiinflammatory drug (NSAID).^1,2 At the suggestion of Hermann Dreser, Bayer's chief pharmacologist at the time,³ the compound was called “aspirin” and was purported to represent a convenient mechanism for the delivery of salicylic acid in the treatment of rheumatic diseases, menstrual pain, and fever.² Approximately 40 years elapsed before Douthwaite and Lintott⁴ provided endoscopic evidence that aspirin could cause gastric mucosal damage. Numerous reports have corroborated this observation,⁵⁸ and the introduction of more potent agents . . .