Most Pain Relievers Unsafe for Inflammatory Bowel Disease
Excruciating joint pain caused Johnson to take ibuprofen by the handful -- eight to 10 200 mg tablets at a time, several times a day, for several months, she says. Joint pain is sometimes seen in people with Crohn's disease, but the pain was only indirectly related to her Crohn's -- it was a byproduct of taking the steroid prednisone off and on for 24 years to control the disease's symptoms.
"I was thrilled when I found ibuprofen because it was the only thing that worked, but I had to keep taking more and more, and finally I realized how crazy it was," Johnson says.
On the advice of her doctor, Johnson now takes much smaller amounts of another NSAID each day, along with a different type of pain reliever and a third medication to reduce diarrhea.
Gastroenterologist Scott Plevy of New York City's Mount Sinai School of Medicine agrees that NSAID pain relievers can cause a worsening of symptoms in patients with bowel diseases like Crohn's and ulcerative colitis, but adds that it is impractical to expect patients to avoid these medications entirely. Plevy, who exclusively treats patients with inflammatory bowel disease, is a spokesman for the Crohn's and Colitis Foundation of America and reviewed this study for WebMD.
"I think physicians who routinely treat patients with Crohn's or colitis are getting the message that these patients should take nonsteroidals cautiously, if at all," he tells WebMD. "But doctors who don't see a lot of inflammatory bowel disease patients may not be aware of this. If nonsteroidals can be avoided in patients with inflammatory bowel disease, they probably should be. However, there are circumstances where these patients may not be able to avoid these drugs. In these cases, under close scrutiny, they probably can be given safely."
Felder says acetaminophen preparations like Tylenol, which do not fall into the NSAID class, are the safest pain relief options for patients with inflammatory bowel disease. But because acetaminophen is not an anti-inflammatory, it may not relieve certain types of pain, like that associated with muscle strain.