For many years, it has been standard for gastroenterologists to tell their patients with inflammatory bowel disease (IBD) to stay away from non-steroidal anti-inflammatory drugs (NSAIDs). The reason to avoid these common over-the-counter painkillers is that they may affect a relapse, or flare-up, of IBD symptoms. Recently, however, the topic has once again come open for debate as new evidence surfaces.
People with IBD are routinely warned against taking NSAIDs, which limits their ability to medicate everyday pain, but also pain from common related conditions such as arthritis. If there is only a small chance that taking an NSAID will cause an IBD relapse, the use of NSAIDs might be helpful for those patients in whom the risk is acceptable. Therefore it is an important issue in the quality of life for patients with IBD.
NSAIDs are drugs that many people take every day for common aches and pains, headaches, and fevers. Available over the counter as ibuprofen, naproxen, aspirin, and many other formulations, NSAIDs are generally safe and effective. NSAIDs may also be prescribed in higher doses by a physician for more persistent discomfort, such as the pain experienced after surgery.
However, there is a downside to taking NSAIDs for pain relief: they can irritate the stomach. The lining of the stomach is weakened and less able to resist stomach acids. This in turn may cause irritation, or more serious conditions such as ulcers, bleeding, or perforation of the stomach lining.
In IBD, the lining of the intestine is already inflamed by the disease process. It is thought that taking an NSAID could exacerbate this effect, causing a relapse or a worsening of symptoms.