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Everyday Pain Relief: Ulcers

Many familiar over-the-counter pain relief drugs can cause harmful side effects for those with ulcers. Here's what you need to know.
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What Are the Risks for People With Ulcers? continued...

For people with ulcers, the risky pain relievers are nonsteroidal anti-inflammatory drugs, or NSAIDs. They include aspirin, ibuprofen, naproxen sodium, and ketoprofen, the active ingredients in medicines such as Bufferin, Advil, and Aleve.

Other pain relievers may be less dangerous. Acetaminophen -- the active ingredient in Tylenol -- works differently and poses a much lower risk of GI problems. However, like any drug, it does have side effects of its own. You shouldn't take any over-the-counter painkiller for more than 10 days without your health care provider's approval.

The risks from NSAIDs are quite serious. Studies show that people who use NSAIDs are about three times as likely to have gastrointestinal bleeding. Even at low doses, NSAIDs can make mild ulcers much worse.

Aspirin has additional risks. "Aspirin can help prevent blood clotting, which is why it helps people at risk of heart attacks and strokes," says Cryer. "But in people with ulcers, it can lead to more serious gastrointestinal bleeding."

However, what if you have an ulcer and a high risk of heart attack or stroke? Then what do you do? Cryer admits that balancing the benefits and risks of these medicines can be tricky.

"People need to talk to their doctors to figure out what's best in their case," he says. But in people with a high risk of heart attack or stroke, he says that the cardiovascular benefits of aspirin can outweigh its gastrointestinal risks.

If you have an ulcer, what should you do the next time you have a headache? In general, people with ulcers should use acetaminophen for over-the-counter pain relief. Unless your doctor has said it's OK, you should not use aspirin, ibuprofen, ketoprofen, or naproxen sodium. If acetaminophen doesn't help with your pain, see your doctor.

Other Options for Pain Relief

Painkillers aren't the only answer for many of life's aches and pains. Many effective and safe alternatives don't have any side effects at all.

  • Ice packs, for acute injuries such as a sprained ankle, can keep down swelling and ease pain.
  • Heat with a hot towel or heating pad can be helpful for treating chronic overuse injuries. (However, you shouldn't use heat on recent injuries.)
  • Physical activity can help reduce some kinds of discomfort, such as arthritis pain.
  • Relaxation with techniques such as yoga or meditation -- may reduce pain. Biofeedback may help as well. These approaches are best for pain that's amplified by stress, such as tension headaches.
  • Nontraditional techniques with low risks -- such as acupuncture -- benefit some people.

So remember: Pain relief doesn't only come from a pill bottle.

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