The use of opioid analgesics combined with non-steroidal anti-inflammatory drug (NSAIDs) for the relief of pain is a risky proposition. NSAIDs are popular prescription and over-the -counter (OTC) choices. This class of medication is utilized often because of its potent analgesic, antipyretic and anti-inflammatory properties. These benefits must be weighed against a risk of gastrointestinal (GI) bleeding. Bleeding can begin just about anywhere in the gastrointestinal tract. As many as 25% of patients using NSAIDs chronically develop gastrointestinal adverse effects.