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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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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.

ASPIRIN
Bayer, Bufferin, Ecotrin (and also an ingredient in Excedrin)

  • How it works. Aspirin is an NSAID that circulates through your bloodstream. It blocks the effects of chemicals that increase the feeling of pain.
  • Benefits. Aspirin has earned its reputation as a "wonder drug." It eases pain and lowers fevers. It can also reduce inflammation, which means that it can treat the symptom (pain) and sometimes the cause (swelling.)

    Aspirin also lowers the risk of blood clots, heart attacks, and strokes, particularly in people at high risk of these problems. Usually, only very low daily doses -- 81milligrams, or one baby aspirin --are recommended for cardiovascular protection. Other NSAIDs (such as ibuprofen, ketoprofen, or naproxen sodium) and acetaminophen do not have this effect. However, you should never start taking aspirin daily without talking with your health care provider first.

  • Side effects and risks. Aspirin can cause or aggravate ulcers. If possible, people who have ulcers should avoid it. Even at very low doses, aspirin can cause gastrointestinal symptoms, such as heartburn, upset stomach, or pain. Coated or "buffered" aspirin does not decrease these risks. Over time, ulcers can cause swelling and a build-up of scar tissue. This can become so severe that it can block food from getting out of the stomach.

    Aspirin can be dangerous for people with liver disease, gout, juvenile arthritis, or asthma. Rarely, aspirin can cause ringing in the ears or hearing loss.

    Pregnant women shouldn't use aspirin, since it can harm the mother and cause birth defects. Unless your health care provider says it's OK, children and teenagers should not use aspirin because it puts them at risk of Reye's syndrome.

    While inflammation can cause pain, it's often a key part of the body's natural healing process. Since aspirin at high doses can prevent inflammation, it can also slow down recovery after certain injuries.

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