In a patient with peptic ulcer disease, which analgesic is generally preferred and why?

• A. Acetaminophen, because NSAIDs can worsen ulcers and cause GI bleeding.
• B. Ibuprofen, because it is safer for ulcers.
• C. Naproxen, because it works faster.
• D. Aspirin, because it prevents ulcers.

Answer: (A)

In peptic ulcer disease, the priority is to relieve pain without worsening the stomach lining. Nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen ulcers and increase the risk of GI bleeding because they block prostaglandins that help protect the stomach. Acetaminophen, on the other hand, provides pain relief without harming the gastric mucosa, so it is safer for someone with a peptic ulcer. The other options are NSAIDs or aspirin, all of which can irritate the stomach and raise bleeding risk, so they’re not preferred. If inflammation is needed, alternative strategies should be discussed with a clinician, but acetaminophen is the safer general choice here.