We all have more or less tasted such as back pain, joint pain and headache in our lifetime, and many people are used to buying painkillers to take when the pain occurs, without realizing that it has laid a safety hazard for the gastrointestinal tract. A 75-year-old woman had a sudden onset of severe pain in her upper abdomen, which quickly spread to her entire abdomen, was persistent, and was accompanied by vomiting. In the hospital emergency room, I saw her body bent with a painful expression and pale face. Physical examination revealed pressure and rebound pain throughout her abdomen, and the entire abdominal wall was as stiff as a wooden board. An abdominal X-ray revealed free gas under the diaphragm in the abdominal cavity. This was a typical patient with gastrointestinal perforation and acute peritonitis, while most elderly people have gastric perforation, often caused by gastric ulcers induced by taking analgesics. She had been suffering from rheumatoid arthritis for more than 10 years and had been taking anti-inflammatory and analgesic drugs for a long time, and her stomach was usually uncomfortable, and she also had tarry black stools many times, and in fact she had severe blood loss anemia, but did not pay attention to it. 1 month ago, she heard a patient say that she had a good effect after taking a certain kind of painkiller, so she asked for a bottle of medicine and ate it, which resulted in a gastric perforation and forced emergency surgery. When she was discharged from the hospital 12 days after surgery, I instructed her that she needed to see a doctor in the future to dispense medication, and that she needed to take anti-inflammatory and analgesic drugs along with gastric mucosal protectors and acid suppressants. In recent years, the trend of gastrointestinal diseases is rising sharply, gastrointestinal diseases once the attack, serious harm, gastric ulcer bleeding or perforation may be life-threatening. Modern people’s mental stress, poor eating habits, irregular life, these are the causes of “injury to the stomach”, but another point is often ignored: many gastrointestinal diseases are caused by the wrong use of analgesics. Among them, NSAIDs are the most widely used analgesics. In 2001, the Asia Pacific Pain Forum stated that “the elimination of pain is a fundamental right of patients”. So, how can we achieve pain relief without hurting the stomach? Patients should be evaluated for gastrointestinal risks when choosing an analgesic. Patients older than 60 years old, alcoholics, smokers, those with a history of peptic ulcers (including a history of upper gastrointestinal bleeding and perforation, and a history of simple peptic ulcers), those using anticoagulants, those using NSAIDs, those using glucocorticoids, those using low-dose aspirin, and those infected with H. pylori are the top nine groups of gastrointestinal risk factors. Therefore, when relieving illness, more consideration should be given to gastrointestinal safety, and patients should ask one more small question: Does this medicine hurt the stomach? Doctors should also ask one more question: Do you have stomach problems? If there is indigestion, heartburn, acid reflux, nausea, abdominal pain, bloating or vomiting of coffee-like substances, black stools and a series of other signals, it is the gastrointestinal tract warning us that we should stop the drug and perform gastroscopy to understand the extent of upper gastrointestinal damage and give appropriate treatment. It is important to seek formal medical channels and inform your medical history and medication history in detail so that your doctor can give more accurate medication guidance. When using non-steroidal anti-inflammatory analgesics, strictly follow the recommended dosage and avoid using multiple analgesics in combination. Since non-selective NSAIDs can cause greater damage to the gastric mucosa, selective NSAIDs that are relatively safe for the gastrointestinal tract should be used. For those who need to take NSAIDs for a long time, enteric tablets can be used, and acid-suppressing and stomach-protecting drugs can be added at the same time to reduce the occurrence of gastrointestinal damage.