Nsaids: Good For The Joints Bad For The Gut
Non-steroidal anti-inflammatory drugs constitute one of the most widely used classes of drugs, with more than 70 million prescriptions annually in the United States. Although NSAIDs are generally well tolerated, adverse gastrointestinal events occur in a small but important percentage of patients. NSAIDs like aspirin, ibuprofen, naproxen, and others are known to have serious adverse effects, including severe gastrointestinal damage, that can be life threatening. These drugs, available both over the counter and by prescription, are widely used for relief of symptoms ranging from minor aches to inflammation and chronic pain.
Research supports the use of interventions to reduce and/or avoid NSAID-associated complications but these strategies are not always applied effectively. This reinforces the need for continued education to improve outcomes of care.
Be sure to discuss the use of any drug with your doctor so that you understand how to use it as directed, are familiar with the risks as well as benefits, and know what to do if side effects occur or symptoms return.
Before Taking This Medicine
Advil can increase your risk of fatal heart attack or stroke, even if you don’t have any risk factors. Do not use this medicine just before or after heart bypass surgery .
Advil may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.
You should not use Advil if you are allergic to ibuprofen, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.
Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:
-
if you take aspirin to prevent heart attack or stroke.
Ask a doctor before using this medicine if you are pregnant or breastfeeding.
If you are pregnant, you should not take ibuprofen unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.
Do not give Advil to a child younger than 2 years old without the advice of a doctor.
Acute Colitis And Autoimmune Disease
NSAIDs are associated with hospitalizations for severe colitis in patients with inflammatory bowel disease and acute colitis, a type of inflammation of the lining of the colon that is due to an infection, medication, or long-term toxin exposure. This is due to the inflammation that NSAIDs cause, as well as leaky gut.
If your leaky gut goes untreated, your immune system stays on high alert and can get confused and start attacking healthy tissues, mistaking them for foreign invaders. This process of mistaken identity is called molecular mimicry.
Its another way that leaky gut syndrome can trigger autoimmune disease. And, once you have an autoimmune disease, leaving your symptoms untreated can cause your condition to progress. This places you at greater risk of developing another autoimmune disease.
All of this may sound frightening, however, the empowering part is that you can take control of your gut health by repairing your leaky gut, and using natural ways to promote a healthy inflammatory response. Lets discuss them.
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Symptoms Of Serious Stomach Issues
The symptoms of stomach problems after taking non-steroidal anti-inflammatory drugs , such as aspirin, ibuprofen, and naproxen, can vary from person to person. Some symptoms can be signs of something more serious like stomach bleeding or ulcers, so it important to recognise the symptoms of these serious stomach problems yourself:
- Extreme abdominal pain
- Vomiting blood or a dark substance
If you experience any of these symptoms, consult with your GP or pharmacist immediately.
S To Heal A Leaky Gut Caused By Ibuprofen
Co-authored by Mark Hyman, MD, a practicing family physician, a seven-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and a regular medical contributor on Katie Couric’s TV show, Katie.
Millions of Americans take over-the-counter painkillers like Advil or Aleve for any random ache, pain, or cold symptom, without a second thought. What most don’t know is that those drugs — called non-steroidal anti-inflammatories — are responsible for over 16,000 deaths per year: that’s more deaths per year than caused by asthma or AIDS.
And, there is another less-recognized side effect — or, more accurately, another less-recognized effect, because side effects are nothing more than unwanted effects of medication. NSAIDs can damage your gut lining, causing a condition responsible for a whole range of ailments, from allergies to autoimmune disease. It’s called leaky gut.
Here’s one girl’s story of recovery:
Sarah is a 5-year-old girl who was brought to us as a patient of The UltraWellness Center by her mom. She came in for the treatment of severe pain and swelling in multiple joints including her ankles, elbows, and fingers.
What Doctors Know… And Don’t Know… About NSAIDs
And not just in kids — in all of us.
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How Should This Medicine Be Used
Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension , and drops . Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.
Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen.
What Do I Need To Tell My Doctor Before I Take Advil Liqui
- If you are allergic to this medicine any part of this medicine or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have an allergy to aspirin or NSAIDs.
- If you have ever had asthma caused by a salicylate drug like aspirin or a drug like this one like NSAIDs.
- If you have any of these health problems: GI bleeding or kidney problems.
- If you have heart failure .
- If you have had a recent heart attack.
- If you are taking any other NSAID, a salicylate drug like aspirin, or pemetrexed.
- If you are having trouble getting pregnant or you are having your fertility checked.
- If you are pregnant or may be pregnant. Do not take this medicine if you are in the third trimester of pregnancy. You may also need to avoid this medicine at other times during pregnancy. Talk with your doctor to see when you need to avoid taking this medicine during pregnancy.
This is not a list of all drugs or health problems that interact with this medicine .
Tell your doctor and pharmacist about all of your drugs and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
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Is It Ok To Take It On An Empty Stomach
This one is kind of two-fold. If youve experienced an upset stomach when taking medications in the past, the FDA recommends taking ibuprofen with food or a glass of milk to reduce the chance youll feel queasy. Longer-term, there is the possibility that NSAIDs can damage the lining of the stomach, which is why its long been believed that food can help cushion the stomach from these effects, though evidence of this has been largely anecdotal. Issues may arise if youre taking ibuprofen for an extended period of time, since it can affect levels of prostaglandin, a lipid that aids in stomach protection. When ibuprofen is taken in large doses or for a long time, less prostaglandin is produced, which can increase stomach acid and irritate the stomach lining, causing problems.
Per a 2009 study at Sheffield Hallam University, Ibuprofen at OTC doses has low possibilities of serious GI events, and little prospect of developing renal and associated events. Ibuprofen OTC does not represent a risk for developing liver injury especially the irreversible liver damage observed with paracetamol and the occasional liver reactions from aspirin.
Now feel better, OK?
Stomach And Digestion Toxicity
One of the most common side effects of ibuprofen when a person takes it at recommended dosages is heartburn. When ibuprofen blocks the COX-1 receptors in the stomach, it can disrupt its protective layer.
People who take too much ibuprofen may experience side effects that range from stomach pain to severe bleeding in the digestive tract. The latter can occur within a few hours of an overdose.
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Ibuprofen May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- constipation
- confusion
- aggression
Ibuprofen may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
If You Take Ibuprofen Every Day You Might Develop An Ulcer
Ibuprofen is taken to relieve pain. However, when taken in excess, the NSAID could actually cause even more pain.
If you’ve ever had an ulcer, then you know just how painful they can be. According to Healthline, ulcers are caused by a reduction in the mucus in your stomach. When that mucus is gone, however, acids start to destroy your stomach lining, which often results in a painful ulcer. And unfortunately, taking ibuprofen daily for too long can actually lead to stomach ulcers, or ulcers that develop in your bowel system. In many cases, these types of ulcers might even lead to an emergency room visit.
“People think that if a medicine is available over-the-counter, it has no risks,” Doctor Byron Cryer, a spokesman for the American Gastroenterological Association told WebMD. He continued, explaining, “But about a third of all ulcers are caused by aspirin and other painkillers.” Added Dr. Cryer, “More than half of all bleeding ulcers are caused by these drugs.” In other words, if you want to avoid a painful ulcer, steer clear of unnecessary ibuprofen.
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How To Minimize The Risk To The Gut
Use Only When Necessary Chronic painful conditions where inflammation plays a minor role such as headache or osteoarthritis may not require NSAID therapy. Acetaminophen is a pain killer without the anti-inflammatory component, and is a better choice if pain relief is the only objective. In osteoarthritis, exercises developed with advice from your doctor, perhaps with the help of a physiotherapist, may help avoid the need for drugs. Despite this, many people with osteoarthritis and other chronic, painful conditions require NSAIDs.
Be Aware of an Individuals Risk of Bad Gut Effects Statistically, older females are most at risk for the adverse gut effects of NSAIDs. Unfortunately, they are the group most likely to benefit from the drugs good qualities. The risk also increases with the duration of treatment, the dose, concomitant use of other NSAIDs or steroids, and the presence of debilitating disease. A history of previous ulcer may also be a warning.
Use the Lowest Effective Dose From the foregoing, it is obvious that one should employ the lowest dose of the drug that is effective, and only for as long as is necessary. Attempts have been made to identify those NSAIDs most likely to damage the gut. Ibuprofen, diclofenac, and naproxen are said to be among the safest. However, reports conflict, and it is difficult to know the risks in relation to efficacy. A safer drug could imply a weaker drug.
Other Complications And Risks
The most common complication from ibuprofen overdoses is metabolic acidosis, in which the body cannot eliminate acidic compounds from its blood and tissues.
The body breaks ibuprofen down into acidic compounds. When a person overdoses on it, the acidic compounds accumulate and can reduce the pH of the blood and body tissues. This makes the body more acidic.
Ibuprofen overdose can cause sudden kidney failure and seizures, which can affect the production and elimination of acidic compounds.
Metabolic acidosis can cause:
- a higher risk of irregular heartbeat
- altered delivery of oxygen through the bloodstream
- immune system impairment
A blood test can reveal a low platelet count following an overdose. Prothrombin time, which is the time it takes for the blood to clot, will also rise. This means that the bodys ability to form blood clots may be reduced.
It is vital for people to seek medical attention immediately if they believe they have ingested too much ibuprofen. In most cases, doctors can reverse the consequences of an ibuprofen overdose.
The emergency doctor will take a complete history of how much ibuprofen the person took and at what time.
It is also vital for the person to mention whether they took other substances with the ibuprofen. Knowing this will help the doctor determine the best treatment and how best to manage the overdose.
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What Are The Side Effects Of Ibuprofen
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.
Stop using ibuprofen and call your doctor at once if you have:
- changes in your vision
- shortness of breath
- swelling or rapid weight gain
- a skin rash, no matter how mild
- signs of stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds
- liver problems–nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice
- low red blood cells –pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating or
- kidney problems–little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath.
Common side effects may include:
- nausea, vomiting, gas
- bleeding or
- dizziness, headache.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What Is The Proper Dosing For Nsaids
When you are trying an NSAID for the first time, take the full dose prescribed every day, unless instructed otherwise. It may take as long as two weeksto build up to a “blood level” of the drug, and the drug may not help very much until then. If you take the drug irregularly, you may never know whether it actually can help you. This could lead to your being switched to a second drug when the first one actually could have helped. Each new drug you take carries a risk of allergic reaction . Therefore, it’s important to find out if a drug can help you before switching to another.
Do not exceed the dose of the drug prescribed. The extra benefit is usually small and the increased risk is significant.
If you are taking the medicine regularly and miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take a double dose. If your arthritis improves, discuss with your physician the possibility of decreasing your dose of the NSAID.
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Ibuprofen Can Interact With Medications
Youre more prone to negative effects if youre taking other medications that ibuprofen doesnt mix well with.
Ibuprofen can interact with the meds youre on, especially high blood pressure medications, which can lead to some serious adverse effects, Dr. Morgan says. That could be deadly.
Ibuprofen can interact negatively with:
- Heart medication, such as clopidogrel.
- Immunosuppressive medication, such as cyclosporine.
- Seizure medication, such as phenytoin.
- Other NSAIDs.
Ibuprofen can impact certain conditions
You should also check with your doctor before taking ibuprofen if you have any of the following conditions:
- Gastrointestinal problems, including heartburn.
- Pregnancy.
How much ibuprofen is safe?
How much ibuprofen you can take depends on, well, you. Theres not really a one-size-fits-all answer, Dr. Morgan says. It depends on your general state of health.
As a general rule, though, Dr. Morgan says most healthy people those who dont have high blood pressure or gastrointestinal issues can typically take ibuprofen on a limited basis to address minor aches and pains.
Its not without risk, but you can feel pretty safe taking it for about three days, she says. Take no more than 400 to 600 milligrams, three times a day, with food. Otherwise, it can ruin your stomach.