NSAIDs Side Effects: Does Taking NSAIDs Injure the GI Tract?

by Chris Centeno, MD /

nsaids side effects

NSAIDs are so commonly prescribed that they might as well be put in the water supply, which would be a good idea if they weren’t so darned dangerous. Due to the severe health risks associated with NSAIDs side effects, even the American Heart Association has pushed to limit NSAID prescriptions. Unfortunately, providers keep prescribing them and the general public keeps popping these toxic painkillers. After all, why would doctors prescribe them, and why would we be able to get them over-the-counter, if they were unsafe? For years I’ve been warning my patients and readers about NSAID use, and I’ve shared many studies that support my warnings. I’ll review those shortly, along with a brand-new study that will answer the title question: Does taking NSAIDs injure the GI tract?

What Are NSAIDs?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are powerful over-the-counter or prescription painkillers that also reduce inflammation. The NSAIDs you can buy off your local drug-store shelf would include ibuprofen (e.g., Advil and Motrin) and naproxen (e.g., Aleve and Naprosyn), while those needing prescriptions would include celecoxib (e.g., Celebrex) and meloxicam (e.g., Mobic), just to name a few. While they may knock out pain with a one-two punch and reduce inflammation (which isn’t always a good thing as good inflammation is needed for proper healing), the power they pack makes them the most dangerous over-the-counter medications you can buy. So you might find relief in taking NSAIDs regularly for your arthritis or back pain, but you’re putting yourself at major risk for a stroke, sudden-death heart attack, or stomach bleeding, for starters. It’s a huge price to pay.

So why are these drugs so dangerous? Let me explain with a review of prior posts I’ve shared with you over the years.

The Many Risks Associated with NSAIDs Side Effects

Of all the risks of NSAIDs side effects, certainly the risk of sudden-death heart attacks is the most troubling. Popping NSAIDs can also increase your risk of dying from rather than surviving a stroke. These two issues alone answer the question, Why are these drugs so dangerous? In 2015, the FDA could no longer ignore the years of research and finally issued warnings for NSAIDs. The American Heart Association has also issued warnings to both physicians and patients to limit or stop NSAID use.

While Naprosyn seems to carry the lowest risk of all the NSAIDs, it still more than doubles your stroke and heart attack risks, and it only gets worse from there. Voltaren carries the highest risk, quintupling your sudden-death heart attack risks. Way back in 2011 (and even before), I was warning readers about stroke and heart attack risks due to NSAID use. Take a look at this breakdown of troubling percentages of the risk of stroke and heart attack, based on 26 studies (and click the link above for even more percentages):

  • Naproxen—increases the risk of stroke by 176%
  • Ibuprofen—increases the risk of stroke by 336%
  • Ibuprofen—increases the risk of sudden-death heart attack by 239%
  • Diclofenac (e.g., Voltaren)—increases the risk of stroke by 286%
  • Diclofenac (e.g., Voltaren)—and sudden-death heart attack by 398%

So the heart attack and stroke risks are clear, but there are other risks as well. NSAIDs can lead the stem cells to produce defective cartilage and prevent normal healing. Taking NSAIDs for arthritis could actually make arthritis in knees and other joints worse. We’ve also known for years that NSAIDs can cause gastrointestinal (GI) issues, like severe GI bleeding, and, now, a new study can be tossed on the growing pile of evidence.

More Evidence NSAIDs Injure the GI Tract

The new study looked at 143 arthritis patients who had taken NSAIDs for greater than one month. During the study, 42 healthy volunteers swallowed a device that looked like a pill, but it actually contained an endoscope that took pictures of the GI tract. Doctors then quantified the number of erosions (i.e., damaged or injured areas) in the bowel. Almost one-third of the osteoarthritis and more than half of the rheumatoid arthritis patients had damage to their gut. The study concluded, “NSAID therapy is associated with a significant risk of small bowel injury.” It doesn’t get much plainer than that.

Rather than risking GI injury and the other dangerous NSAIDs side effects of these drugs, maybe we need to convince our doctors to actually fix our pain problem rather than throwing NSAIDs at our symptoms. The truth is, some of us have been taking NSAIDs for so long, it borders on addiction. But you can get off the NSAID sauce. Read “Are You an NSAID Addict? What Can You Do?” for help.

The upshot? Taking NSAIDs injures not only the GI tract but so much more! It’s perplexing to me that while the FDA and the AHA has issued hard warnings about NSAIDS, and study after study continues to prove the dangers of these drugs, NSAIDs are still widely used and abused by patients and overprescribed by doctors. Glucosamine and chondroitin, for example, are safer natural alternatives that have been shown to be effective and powerful when used together, so why isn’t big pharma working toward safer alternatives for NSAIDs?

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5 thoughts on “NSAIDs Side Effects: Does Taking NSAIDs Injure the GI Tract?

  1. Edy Johnson

    I agree one hundred percent!!

  2. Janet

    Then what can we take for pain

    1. Regenexx Team Post author

      Janet,

      Curcumin works well for pain: Please see: http://www.regenexx.com/curcumin-for-knee-arthritis/

  3. Kent

    I Have Two Knees Bone On Bone. My Dr Gave Me Mo-ab And Naproxian. I Read The Risk On Them And Talked To Him About The Risk. He Said That Was All B.S. And That I Should Take What He Gives Me. Well I Think He Is B.S. And I Choose To Take Plain Old Asprin. Who Is Right In This Argument.

    1. Regenexx Team Post author

      Kent,
      Though aspirin is also an anti-inflammatory and therefore delays healing, it does not have the cardiac or stroke risk of ibuprofen, naproxen, and the prescription NSAIDs. It also does not have the specific cartilage gene issue that naproxen (Aleve) does. So, I think you won this round!

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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