You might think that over-the-counter pain relievers are harmless but like any medication, they can cause side effects—especially if they are used improperly. Many over-the-counter and prescription pain medications are members of a class of drugs called nonsteroidal anti-inflammatory drugs, or NSAIDs. We take them to reduce pain and inflammation, and to protect against heart attack and stroke. And if you read your labels closely, you will also see them in some sinus and cold medicines.
Few people realize that NSAIDs can cause gastrointestinal problems ranging from simple indigestion to potentially life-threatening bleeding ulcers. Major complications can sometimes develop without warning after years of use, making it difficult for people to realize that they are at risk. In the United States, there are more than 100,000 hospitalizations per year and thousands of deaths per year attributable to NSAIDs.
Below, Dr. Byron Cryer, an associate professor of internal medicine at the University of Texas Southwestern Medical School, and Dr. George Triadafilopoulos, a professor of medicine at Stanford University School of Medicine, discuss how to prevent the gastrointestinal side effects associated with these common pain relievers.
What are NSAIDs?
BYRON CRYER, MD: NSAIDs are pain medicines that are commonly taken for conditions such as headaches, arthritis or various aches and pains. NSAIDs are the most frequently and the most commonly used class of medicine worldwide because they can be applied to so many different types of conditions.
You can get NSAIDs over-the-counter or by prescription. Some of the common over-the-counter brands are aspirin, ibuprofen and naproxen. They go by trade names such as Aleve, Advil, Motrin and Bayer.
What side effects are associated with the use or overuse of NSAIDs?
BYRON CRYER, MD: The most common side effects are harmful effects in the gastrointestinal tract such as the stomach and the intestines such as ulcers. Ulcers occur in the lining of the stomach or the intestine and may cause bleeding or holes, which we call perforations.
GEORGE TRIADAFILOPOULOS, MD: In up to 20 percent to 30 percent of people, NSAIDs may be associated with the development of gastrointestinal distress such as discomfort in the stomach, sensation of nausea, a burning feeling in the stomach, heartburn and indigestion.
