Published online Aug 6, 2013. doi: 10.4292/wjgpt.v4.i3.39
Revised: June 21, 2013
Accepted: June 28, 2013
Published online: August 6, 2013
Processing time: 161 Days and 15.2 Hours
Steroid ulcers, although a common feature in experimental studies, seldom develop in clinical practice, as observed by the meta-analyses carried out in the 90s. Corticosteroids alone become ulcerogenic only if treatment lasts longer than one month and the total administered dose exceeds 1000 mg. On the other hand concomitant intake of non-steroidal anti-inflammatory drugs results in a synergistic, highly damaging effect on the gastroduodenal mucosa. Thus, despite the survival of the steroid ulcer myth in the medical culture, pharmacological protection against steroid-induced peptic ulcers is a rare necessity while the best prophylactic strategy still remains to be determined.
Core tip: Although the myth of steroid ulcers still survives among general practitioners, the incidence of ulcers in patients receiving corticosteroids is so low that concomitant gastric protection is not necessary except in patients on long-term, high-dose steroids or taking concomitant non-steroid anti-inflammatory drugs.