Americans love ibuprofen. Some have taken to calling it vitamin I because they rely on it so often to relieve pain. But ibuprofen and naproxen can cause life-threatening ulcers. Just because they are sold over the counter does not make such NSAIDs safe. Prescription NSAIDS like celecoxib, diclofenac and meloxicam can also cause life-threatening ulcers. Here is one patient who got into very serious trouble:
NSAIDs and Life-Threatening Ulcers:
Q. I have a friend who fell off a ladder last month and injured his back. He is not a complainer, so he took big doses of ibuprofen for the pain and kept on with most of his daily activities.
Last week, he suddenly started losing a lot of blood in his stool. He felt weak, and his wife rushed him to the hospital. The doctors discovered that he had serious bleeding ulcers as a result of the ibuprofen. He needed several units of blood.
A surgeon had to use an endoscopy scope to get into his stomach and cauterize the largest ulcer so it wouldn’t continue bleeding. This drug is more dangerous than most people recognize.
A. You are quite right about the dangers of NSAIDs such as ibuprofen (Advil, Motrin IB) and naproxen (Aleve). They can irritate the digestive tract. Bleeding in the upper GI tract can be triggered by life-threatening ulcers.
What Researchers Have to Say:
A study in the journal BMC Gastroenterology (June 5, 2009) noted:
“Some people who suffer an upper gastrointestinal bleed or perforation die. The mortality rate was estimated at 12% in studies published before 1997, but a systematic survey of more recent data is needed…
“Data published since 1997 suggest that overall mortality in any patient with a bleed or perforation has fallen over time but is still about 1 in 13. Not unexpectedly, mortality is even higher in patients with a bleed or perforation who are exposed to NSAID or aspirin. New knowledge is that in these patients, mortality appears to have increased over time to about 1 in 5 since 1997. Reasons for this increase remain to be elucidated.”
We suspect that few people understand that an over-the-counter NSAID-type pain reliever can cause life-threatening ulcers. Some people are super-sensitive to NSAID side effects. Others seem able to tolerate pretty high doses. But the longer people take such drugs and the higher the dose the greater the risk.
More Stories from Visitors to This Website:
Tom in Florida wrote about Aleve (naproxen):
“I took Aleve , 1 a day for 6 weeks and developed 3 ulcers in my stomach. I awoke to a bleeding stool.
“I went to the ER, and a physician cauterized all three ulcers. One wasn’t fully cauterized and kept bleeding. It was re-cauterized 2 days later.
“I lost 3 pints of blood. I was in hospital for 5 days. They put me on a liquid diet. I lost 10 lbs.
“All is now well. I asked the doctor what percent he thought the Aleve had to do with the ulcers, and he replied ’99 percent sure’ they caused the ulcers. Some can, some can’t take Aleve. Be aware.”
Like so many people, Leslie in Chicago is caught on the horns of a dilemma:
“I suffer from arthritis pain that makes it hard for me to breathe some days. NSAIDs work, but I’m definitely anxious about what I’m doing to my liver and kidneys and the risks of bleeding ulcers or cardiac problems.
“Behind-the-counter status for NSAIDs would make it necessary for a pharmacist to review the side effects and check for bad drug interactions. I don’t love the idea, but there’s merit in considering it.”
B.J. in western New York state has a nurse’s perspective:
“Been through the mill with pain meds thanks to being a disabled nurse/NP. Meloxicam is an NSAID just like naproxen, ibuprofen, diclofenac, Vioxx, Duract (bet most of you missed that one) Torodol (ketorolac) and to a degree, even aspirin.
“Side effect profiles, chances of allergies, high blood pressure, bleeding ulcers/bowels/bruising all comparable as is the increased heart attack risk or stroke.
“More and more of us are looking at herbal tinctures or ointments/essential oils that are diluted and rubbed on sites. 1. No first pass through the liver. 2. No pass through the stomach. 3. Reduction to almost nil of drug interactions. 4. No withdrawal issues.
“They need to be blended/diluted by someone with a background in essential oils or skin irritation can be a major problem (most common) and so they are tailored to your specific needs. Remember, even something applied to the skin is still a drug. I was in the medical field. I’m sick of scripts and side effects.”
People’s Pharmacy Perspective:
We appreciate B.J.’s thoughts. Aspirin is much less likely than other NSAIDs to cause heart attacks or ischemic strokes. There are data to suggest aspirin can prevent blood clots. It can, of course, cause life-threatening ulcers.
Even something you apply to the skin can produce complications. Learn more about topical NSAIDs vs. oral NSAIDs in our brand new book, Alternatives for Arthritis. In addition, find out about herbal anti-inflammatory products and home remedies that are far less likely to cause life-threatening ulcers. You can read more about this 104-page book at this link.
