<P> A 2011 publication in The Journal of Urology received widespread publicity . According to this study, men who used NSAIDs regularly were at significantly increased risk of erectile dysfunction . A link between NSAID use and erectile dysfunction still existed after controlling for several conditions . However, the study was observational and not controlled, with low original participation rate, potential participation bias, and other uncontrolled factors . The authors warned against drawing any conclusion regarding cause . </P> <P> The main adverse drug reactions (ADRs) associated with NSAID use relate to direct and indirect irritation of the gastrointestinal (GI) tract . NSAIDs cause a dual assault on the GI tract: the acidic molecules directly irritate the gastric mucosa, and inhibition of COX - 1 and COX - 2 reduces the levels of protective prostaglandins . Inhibition of prostaglandin synthesis in the GI tract causes increased gastric acid secretion, diminished bicarbonate secretion, diminished mucus secretion and diminished trophic effects on the epithelial mucosa . </P> <P> Common gastrointestinal ADRs include: </P> <Ul> <Li> Nausea / vomiting </Li> <Li> Dyspepsia </Li> <Li> Gastric ulceration / bleeding </Li> <Li> Diarrhea </Li> </Ul>

Mechanism of action of nsaids in rheumatoid arthritis