Can I Take NSAIDs if I have Crohn’s Disease?

Non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen, can be great for handling aches and pains. But if you have Crohn’s disease, you need to be careful about taking them.

Some people with the condition can take these medicines without problems, but a few studies suggest that they could make Crohn’s symptoms flare or may make the condition worse overall. If you need pain relief, it’s best to check with your doctor before you take these drugs and talk about how they might affect you.

Inflammation From Anti-Inflammatory Drugs

People with Crohn’s disease have inflammation inside their digestive system, usually in the small or large intestines. NSAIDs are supposed to block inflammation in your body. So how do they make Crohn’s worse?

The drugs work by lowering the levels of hormones in your body called prostaglandins. These chemicals have many jobs, including causing pain and inflammation when your body gets damaged or infected. In your gut, they do two things: They help control how much acid your gut makes to digest your food, and they help the mucus on the walls of your gut provide protection from the acid. With fewer prostaglandins, you have more acid and less protection, and that irritates and inflames your gut.

Other Pain Relief Options

Like everybody else, people with Crohn’s get headaches, backaches, and pulled muscles. Talk to your doctor about what kind of pain relief is safe for you. For mild pain, she may suggest acetaminophen.

Other painful conditions, such as arthritis, can be more complicated. NSAIDs are often the first kind of treatment people try for arthritis. Not everyone with Crohn’s will have a problem taking the drugs, so talk to your doctor about whether you should try one and see what happens. She may suggest other types of drugs, such as corticosteroids or sulfa drugs, to help your arthritis pain.

One type of drug, called celecoxib (Celebrex), may be another option. It is an NSAID, but it works differently than the everyday ones you can buy at the drugstore. Doctors are still learning whether it can trigger flares in Crohn’s disease, but some research suggests that it might be OK.

You can also try other ways to relieve pain without taking medicine, such as:

  • Rest
  • Ice or moist heat
  • Physical therapy

WebMD Medical Reference Reviewed by Minesh Khatri, MD on April 04, 2018

Sources

SOURCES:

Crohn’s and Colitis Foundation: “Arthritis,” “What are Crohn’s and Colitis?”

Journal of Clinical Gastroenterology: “Role of Non-Steroidal Anti-Inflammatory Drugs in Exacerbations of Inflammatory Bowel Disease.”

Harvard Medical School: “Crohn’s Disease.”

Annals of Internal Medicine: “Aspirin, Nonsteroidal Anti-inflammatory Drug Use, and Risk for Crohn’s Disease and Ulcerative Colitis: A Cohort Study.”

Clinical & Investigative Medicine: “Role of endogenous prostaglandins in gastric secretion and mucosal defense.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Treatment for Crohn’s Disease.”

Gastroenterology & Hepatology: “Managing Pain in Inflammatory Bowel Disease.”

University of Washington Medicine: “Inflammatory Bowel Disease.”

Pharmaceuticals: “Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study.”

Hormone Health Network/The Endocrine Society: “What is Prostaglandins?”

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