How are aspirin and NSAIDs managed following an episode of peptic ulcer bleeding?
- Patients with bleeding peptic ulcer disease should be tested and treated for Helicobacter pylori infection.
- Eradication of infection should be documented. NSAIDs should be stopped.
- If this is not possible, a coxib plus a PPI should be used. In general, low-dose aspirin for secondary prevention of cardiovascular disease should be resumed shortly after bleeding is controlled along with a PPI.
- Aspirin for secondary prevention should be stopped in most cases.
- Patients in whom the cause of ulcer disease is unknown should be continued on a PPI indefinitely.
