Which patient factor increases the risk of NSAID-related gastrointestinal bleeding?

• A. Regular exercise.
• B. History of peptic ulcer disease.
• C. Vegetarian diet.
• D. Non-NSAID analgesic use.

Answer: (B)

The main concept here is that prior damage to the stomach lining increases the risk of NSAID-induced bleeding. NSAIDs reduce protective prostaglandins in the gastric mucosa, making the lining more susceptible to injury. If someone has a history of peptic ulcer disease, the mucosa is already compromised and more prone to ulcers and bleeding when exposed to NSAIDs. That combination substantially raises the chance of a significant GI bleed compared with someone without a prior ulcer.

Other options don’t inherently raise this specific risk. Regular exercise and a vegetarian diet don’t create vulnerability in the gastric lining for NSAIDs. Using a non-NSAID analgesic avoids the NSAID-related mechanism of mucosal injury, so it doesn’t contribute to NSAID-specific GI bleeding risk.