Figure 4: Harmful effects of using NSAIDs on gastroduodenal layers, like it decrease the protective mucosal endogenous prostaglandins (PGs) and intestinal mucus, disrupt the intercellular junctions which lead to infiltration of enterobacteria, viruses etc, increase mucosal permeability and intestinal motility abnormally. Consequently, these all factors lead to penetration of bile acid, proteolytic enzymes, intestinal bacteria and toxins causing epithelial cells damage and hence ulceration. PPIs increase heme oxygenase protein (HO-1), in the intestinal mucosa helping develop and proliferate the tissues. It also inhibits inflammatory cytokines and neutrophil activation [27].