Mr K is a 67-year-old military veteran with decompensated alcohol-related cirrhosis with ascites, as well as hepatic encephalopathy (HE), and was admitted to intensive care because of melena. Upper endoscopy revealed multiple oozing gastric ulcers without varices. On questioning after stabilization, the patient admitted to taking over-the-counter nonsteroidal antiinflammatory drugs (NSAIDs) owing to severe gum and tooth pain. He was ineligible for Veterans Affairs–based dental coverage and could not afford private dental care.
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