A causal relationship is now firmly established between nonsteroidal
anti-inflammatory drug (NSAlD) use and the occurrence of peptic ulcer
complications. In the United Kingdom, rising NSAID use has been matched by
rises in ulcer mortality and perforation rates, particularly in older women. It is
not likely, however, that drug use accounts for the entire increase. The reasons
why some people develop ulcer complications and others do not are poorly
understood. It is plausible to propose that other factors, such as history of ulcer
or indigestion, current smoking, and alcohol consumption, might raise this risk;
however, supportive evidence is lacking
