Medical Health Encyclopedia

Ibuprofen (Motrin, Advil, Nuprin, Rufen)

Naproxen (Aleve, Naprosyn, Naprelan, Anaprox)

Diclofenac (Voltaren) Tolmetin (Tolectin)

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NOTE: Drugs within the medium risk group vary in risk. For example, studies show that use of naproxen is twice as likely as ibuprofen to be associated with hospitalization from GI bleeding.

Flurbiprofen (Ansaid) Piroxicam (Feldene) Fenoprofen Indomethacin (Indocin) Meclofenamate (Meclomen)

Ketoprofen (Actron, Orudis KT) NOTE: Ketoprofen is often considered a medium-risk drug, but one study reported that taking the drug even one week at low doses causes significant GI injury.

Zollinger-Ellison Syndrome (ZES)

What is ZES?

The least common major cause of peptic ulcer disease is the Zollinger-Ellison syndrome (ZES). In this condition, gastrinomas (tumors in the pancreas and the duodenum) produce excessive amounts of gastrin, a hormone that stimulates gastric acid formation. These tumors are usually malignant, so proper and prompt management of the disease is essential.

Who Gets ZES?

The incidence of ZES in the United States is estimated at one case per million people per year, and at 0.1% to 1% among patients with peptic ulcers. The mean age at onset is 45 to 50 years, and men are affected more often than women.