Long-term NSAID side effects: discuss with your doctor to make sure the benefits outweigh the risks. 🩺 Stomach ulcers NSAIDs block COX-1 prostaglandins that protect the stomach lining (mucus, bicarbonate, blood flow), and they can directly irritate the mucosa. Long-term users have substantial rates of endoscopic ulcers and “silent” injury. PMID: 39327242, 37053160, 3048080, 27713351 🩸 Internal bleeding Less mucosal protection plus impaired platelet aggregation increases GI bleeding risk. Bleed