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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.

What Are the Risks for People With Ulcers? continued...

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.

The Pros and Cons of Pain Relief Drugs

Here's a rundown of the benefits and risks of some popular pain medications. It should help simplify your choices when you're in the drugstore.

Keep in mind that you shouldn't use any over-the-counter painkiller on a regular basis. If you're in that much pain, you need to talk with your doctor.

ACETAMINOPHEN
Tylenol, Panadol, Tempra (and also an ingredient in Excedrin)

  • How it works. Acetaminophen is not an NSAID. Experts aren't actually sure how it works, but it seems to affect chemicals that increase the feeling of pain.
  • Benefits. Acetaminophen reduces pain and lowers fevers. Unlike aspirin and other NSAIDS, acetaminophen is believed to be safe for people with ulcers. It doesn't affect the natural lining of the stomach. Since it doesn't thin the blood, it doesn't increase the risk of bleeding either. It is safe for women who are pregnant and nursing.
  • Side effects and risks. Experts say that acetaminophen is safe for people with ulcers. But like any drug, it can cause other side effects. Very high doses of acetaminophen -- well over the recommended maximum of 4,000 mg/day -- can cause serious liver damage. Long-term use of acetaminophen in high doses -- especially when combined with caffeine (Excedrin) or codeine (Tylenol with Codeine) can cause kidney disease.

    Acetaminophen doesn't reduce swelling, like aspirin and other NSAIDs do. It may be less helpful for treating pain that's caused by inflammation, such as some types of arthritis.

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