Non-steroidal anti-inflammatory (NSAID) medications are often a first-line recommendation for over-the-counter (OTC) pain management.
They can treat aches and pains from illness, headaches, menstrual cramps, and other common conditions.
However, somegastroenterologistsrecommend that IBD patients stay away from NSAIDs.
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While they may be okay sometimes, several alternatives exist.
COX-1 plays a role in the digestive system, and COX-2 in the inflammatory process.
The prostaglandins synthesized by COX-2 mediate the inflammatory process and the pain response.
NSAIDs typically aren’t great at only blocking COX-2, which is responsible for pain and inflammation.
Most also block COX-1, which plays a role in gut protection.
Some prescription NSAIDs are more specific to COX-2 and may do less damage to the GI tract.
In addition to their role as COX inhibitors, other mechanisms of NSAIDs can further damage the GI tract.
NSAIDs may directly impact the protective mucosal layer of the GI tract and negatively affect its metabolism.
Do NSAIDs Cause IBD?
Additionally, NSAIDs can cause inflammation and worsen bleeding in the small intestine.
Up to 30% of long-term NSAID users may experience ulcers or erosions.
Can People With IBD Take NSAIDs?
Additionally, COX-2 inhibitors tend to be more specific to inflammation without inhibiting protective prostaglandins.
COX-2 inhibitors are available only with a prescription.
Celecoxib (brand name Celebrex) is the COX-2 inhibitor available in the United States.
Below is a table with several NSAIDs listed.
It is not an exhaustive list.
If you have IBD or are concerned about the side effects of NSAIDs, contact your healthcare provider.
However, whileacetaminophen can help reduce pain, it does not decrease inflammation.
So, those with inflammatory pain conditions may require additional treatment.
Prescriptionaminosalicylatesare also sometimes a treatment option for those with Crohn’s and IBD.
The main aminosalicylate used is sulfasalazine.
Sulfasalazine is an effective treatment for ulcerative colitis but is not regularly used for Crohn’s disease anymore.
Contact your healthcare provider for advice so they can tailor a pain management treatment plan to your specific needs.
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