OBJECTIVES: To explore the impact of upper gastrointestinal (GI) symptoms, defined as upper abdominal pain, discomfort or burning, in chronic NSAID users on their ability to work and carry out daily activities. METHODS: A productivity questionnaire was administered to Swedish patients (n = 77) participating in an international placebo-controlled clinical study (n = 556) on the efficacy of 4 weeks of esomeprazole treatment in a non-ulcer population with upper GI symptoms associated with continuous NSAID use. Productivity measures included disease-specific absence from work, reduced productivity while at work, and reduced productivity while carrying out regular daily activities during the preceding week. Responders and non-responders (irrespective of treatment) were identified by use of symptom diaries (primary measure in clinical study). RESULTS: Evaluable productivity data were obtained from 61 patients (41 responders; 20 non-responders), of which 44% (27: 14 responders; 13 non-responders) were employed. Before start of treatment, patients reported an average of 0.4 hours absence from work per week, 13% reduced work productivity and 26% reduced productivity in activities. The mean difference between responders and non-responders after treatment was 0.7 hours (p = 0.18) for absence from work, 12% units (p <0.05) for reduced work productivity and 16% units (p <0.01) for reduced productivity in activities. On a weekly basis, results thus imply that treatment success is associated with an avoided loss of work productivity of 4.6 hours per patient employed, of which 3.9 hours are due to reduced work productivity (% reduced productivity x hours worked). Further, high and statistically significant change score correlations between symptoms, disease-specific quality of life dimensions and reduced productivity measurements were found, lending support to validity of these measurements. CONCLUSIONS: Despite the relatively small population sample, results indicate that successful treatment of upper GI symptoms in chronic NSAID users has a significantly positive impact on their ability to work and carry out daily activities.