Nearly every arthritis sufferer has taken a traditional painkiller like
aspirin or Aleve. They are a great solution for relieving pain and
inflammation, but there's a definite downside. These drugs often lead to more
trouble including upset stomach and bleeding ulcers.
There are some 20 traditional nonsteroidal anti-inflammatory drugs or
NSAIDs, including aspirin, ibuprofen (Advil and Motrin), naproxen (Aleve),
indomethacin (Indocin), and piroxicam (Feldene).
Hearing your doctor utter the words, "We’re going to have to operate," can
send a shiver down your spine. Immediately, questions about the seriousness of
your condition, the procedure itself, and the likelihood that it will cure what
ails you flood the mind. Then, there is the prospect of post-surgery pain. How
badly is this going to hurt?
The bad news is that some pain is an inevitable companion to most types of
surgery. The good news is that there are many highly effective medications to
These drugs can bother the GI tract in a number of different ways, says
Robert Hoffman, MD, chief of rheumatology at the University of Miami Miller
School of Medicine. "Gastritis, esophageal reflux disease [heartburn or
GERD], and bleeding ulcers are all problems that can develop from
Though there are a few things you can do to reduce stomach upsets, there are
no guarantees that serious problems won't develop - serious enough to mean
hospitalization and even death, he adds. Older people with other medical
problems are at especially increased risk.
"If you're taking NSAIDS on a chronic basis, there's a very high
percentage risk that you will develop significant symptoms," says Hoffman.
The bottom line: "Don't treat an arthritis problem on your own. See a
To keep yourself safe:
Use short term only. The FDA advises that over-the-counter
NSAIDS be taken only for 10 days or so. Some people can control their pain this
way, with no serious risks.
Take with food and water. Taking painkillers with a glass
of water and a bit of food seems to ease stomach upsets. Sometimes taking an
NSAID with an antacid or calcium supplement can help.
Stop bad habits. Alcohol and cigarette smoking will up your
risk of stomach problems.
Change time of day. Taking an NSAID in the afternoon or
evening sometimes eases stomach upsets.
Check with your pharmacist. Are you taking other
medications besides an NSAID? Some medications taken together can increase your
risk of side effects. For instance, a blood thinner like Coumadin plus an NSAID
can increase your risk of bleeding. Talk with your pharmacist or a doctor if
you're taking another medication and an NSAID.
Know symptoms of trouble. "Sour stomach, abdominal
pain, dark stools, bright blood in stools, and passing out -- these are all
symptoms of problems like stomach ulcers," says Hoffman. However, many
people don't have any symptoms even though they have serious or
life-threatening bleeding, he adds. Another symptom is vomiting blood or
material that looks like coffee grounds.
See a doctor for chronic pain. If you need extended relief
for ongoing arthritis pain, get yourself to a doctor. That's the only way to
really know if you have symptoms of stomach problems. Some patients are
candidates for the Cox-inhibitor Celebrex or one of several prescription drugs
called "selective" NSAIDs like Salsalate or Voltaren. Studies show that
these drugs may cause fewer GI problems. Certain forms of arthritis could be
treated with steroids or other specific treatments. Also, certain non-NSAID
painkillers like Tylenol (acetaminophen) appear to be safe when taken under a
doctor's supervision for some forms of arthritis.
Consider a second medication. Taking a second drug can
reduce your risk of side effects related to traditional NSAIDs, says Hoffman.
Among the options: an acid-blocking drug like Prilosec; an acid-reducing drug
like Zantac; a histamine blocker like Tagamet; or an ulcer-preventive drug like
Cytotec. A few combination drugs do include an NSAID plus a stomach-protective
drug; these are available by prescription only.