Common Painkillers Linked to Increased Risk of Stomach Bleeds, Especially in Vulnerable Groups
London, UK – Widely used non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, while effective for pain relief, carry a risk of stomach bleeding, prompting renewed warnings for certain individuals. While infrequent use of over-the-counter NSAIDs presents a minimal risk, regular use – or use within specific high-risk groups – can lead to serious complications.
NSAIDs don’t simply mask pain; they work by reducing inflammation,but this mechanism can also interfere with the stomach’s protective lining,bleeding rather than negating it. Balancing potential risk against day-to-day benefits is crucial, but some groups should be notably cautious.
These include individuals on low-dose aspirin (or clopidogrel) or anticoagulants like warfarin and apixaban, those prone to indigestion, heartburn, or with a history of stomach or duodenal ulcers, and people with heart failure and chronic kidney disease. Anyone over 65 not concurrently taking gastroprotection medication, such as omeprazole, is also considered at higher risk.
A common question raised by patients concerns the use of NSAID suppositories, as practiced more frequently in France. Despite the altered delivery method, the drug still enters the bloodstream and retains its deleterious effect on the stomach. While occasionally prescribed in the UK, suppositories haven’t gained widespread acceptance.
Early signs of upper gastrointestinal bleeding can include black, tarry stools (melaena) – a symptom that is often unreported. Vomiting blood is a more obvious,and urgent,warning sign.
Beyond stomach bleeds,NSAIDs can also increase the risk of heart attack and stroke,worsen heart failure,and contribute to atrial fibrillation and raised blood pressure.The risk of heart complications increases with age and dosage. They can also reduce blood flow to the kidneys, possibly causing acute kidney failure, particularly in those with pre-existing kidney issues. Approximately 1 in 20 people taking regular NSAIDs experience fluid retention, often manifesting as swollen ankles, and NSAIDs can exacerbate asthma in some individuals.
For occasional pain,paracetamol is generally considered a safer option to ibuprofen,although it may be less effective. Individuals requiring regular pain relief should consult their GP to determine the most appropriate course of action. aspirin should be avoided unless specifically prescribed by a doctor.
