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.