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Even though the NICE Guideline says that patients may need more frequent injections GPs are still largely ignoring or unaware of this guidance

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NSAID-Induced Gut Damage: A Specific Research Context Non-steroidal anti-inflammatory drugs (NSAIDs) cause significant gastrointestinal damage through prostaglandin synthesis inhibition prostaglandins are critical for mucosal maintenance, and their suppression leads to reduced mucus production, decreased bicarbonate secretion, and impaired mucosal blood flow

Hypoxia contributes to vascular changes such as increased stiffness, tortuosity, and decreased vascular perfusion

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