Avoiding NSAIDs in IBD
A common question from patients is: "Why is it recommended that non-steroidal anti-inflammatory medications (NSAIDS), such as ibuprofen, be avoided in IBD?"
While NSAIDs can serve as potent anti-inflammatory medications to treat things such as joint pains and backaches, they can have a paradoxical pro-inflammatory effect on the GI tract. The reason this happens is that the GI tract needs multiple lines of defense to protect its inner lining (think of all things the GI tract must be able to withstand - food, stomach acid, bile, medications, alcohol). One of the defense mechanisms our body uses to protect the GI tract is the secretion of hormone-like chemicals called prostaglandins. Prostaglandins help protect the intestinal lining against ulcer formation and aid in healing the GI tract when the protective barrier is broken. NSAID medications inhibit the production of prostaglandins throughout the body, and therefore leave the lining of the GI tract vulnerable to various insults. Furthermore, studies have demonstrated an association between NSAID use and increased risk of IBD flares. It is thought that a reduction in prostaglandin levels in the GI tract may account for this observation.
As such, IBD patients are counseled to avoid products pain relievers and cold medicines that contain ibuprofen. Alternative pain medications that are safe for most IBD patients include acetaminophen and tramadol. Patients with questions about which pain medication is best for them should consult with their physician