Abstract
Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are the two most important risk factors for peptic ulcer disease1. The population-attributable risk associated with peptic ulcer is estimated at 48% for H. pylori infection and 24% for NSAID use, respectively2. Results from numerous randomized controlled clinical trials have shown that eradication of H. pylori infection cures most peptic ulcers and virtually eliminates ulcer recurrence3,4. Although the management of NSAID-related peptic ulcer is more difficult than that of H. pylori-associated ulcers, the simplest and most effective treatment is to discontinue the NSAIDs5, suggesting a strong causal relationship between NSAID use and peptic ulcer disease.
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