Impact of NSAID-Induced COX-1 Inhibition on Gastric Mucosa and Associated Complications

DESCRIPTION

Nonsteroidal anti-inflammatory drugs (NSAIDs) can inhibit COX-1, leading to significant alterations in the gastric mucosa. This inhibition reduces prostaglandins, which are crucial for mucosal protection, resulting in decreased mucin and bicarbonate secretion and increased gastric acid production. Such changes compromise the mucosal defense system, impair epithelial cell proliferation, and reduce blood flow, ultimately causing ulceration and deeper mucosal damage. Complications may include GI bleeding, melena, and coffee-ground emesis due to injury to blood vessels.

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Apr 28, 2026

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Impact of NSAID-Induced COX-1 Inhibition on Gastric Mucosa and Associated Complications

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PATHOPHYSIOLOGY
NSAID use COX-1 inhibition Migrate across the lipid membrane of epithelial cells ↓prostaglandins in the gastric mucosa Ion trapping ↓mucin secretion ↓HCO3 secretion ↑HCl secretion ↓epithelial cell proliferation ↓mucosal blood flow Direct epithelial cell toxicity Impairment of mucosal defense system
Disruption of mucosal integrity NSAID use ULCERATION Inhibition of TXA2 Ulcer burrow deeper into the gastric mucosa ↓platelet aggregation Injury to the blood vessels GI BLEEDING Melena Coffe-ground emesis