Open AccessRefractory gastric ulcer due to undisclosed use of topical diclofenac epolamine patches
Author(s) -
Oda Yuta,
Naito Hiromichi,
Nojima Tsuyoshi,
Nakao Atsunori
Publication year - 2021
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.710
Subject(s) - medicine , diclofenac , omeprazole , discontinuation , nonsteroidal , proton pump inhibitor , refractory (planetary science) , over the counter , adverse effect , drug , sucralfate , pantoprazole , anesthesia , pharmacology , physics , astrobiology , medical prescription
Background Topical forms of nonsteroidal anti‐inflammatory drugs (NSAIDs) have been created to lessen systemic adverse effects. In general, they are believed to be well tolerated and appropriate for use as an over‐the‐counter (OTC) drug. Case Presentation A 68‐year‐old woman visited our clinic due to tarry stool. The patient reported multiple episodes of recurrent bleeding from a gastric ulcer for 2 months and was treated with endoscopic hemostatic clipping. The patient disclosed she had been using a large number of diclofenac patches for more than 3 months. The patient was treated conservatively by discontinuation of diclofenac patches and treatment with a proton pump inhibitor and omeprazole. Conclusion In conclusion, inappropriate use of topical NSAID patches can be a cause of peptic ulcer bleeding. Patients reporting multiple episodes of recurrent bleeding from a gastric ulcer should be questioned, particularly about the use of OTC medications that might include topical NSAID patches.