A lot of what we know is not correct---you have to keep checking for
conclusions based on later studies---NSAIDS being one example. Last
August the conclusion of the medical community was that up to 3600 Mg
per day of Ibuprofen wouldn't hurt you. Wrong!
Here's the latest: Note that Tylenol is nor a NSAID, but has its own set
of hazards, i.e. he top recommended doses of acetaminophen are 4 grams a
day -- that's eight extra-strength tablets -- for adults and 90
milligrams per kilogram a day for children. A single dose of 150 mg per
kilogram, or about 7 grams, is considered poisonous to the average adult.
Study Shows Long-term Use Of NSAIDs Causes Severe Intestinal Damage
Bethesda, Maryland (Jan. 3, 2005) – According to a study published today
in the American Gastroenterological Association (AGA) journal Clinical
Gastroenterology and Hepatology, chronic users of non-steroidal
anti-inflammatory drugs (NSAIDs) have an increased risk of bleeding and
visible damage to their small intestine.
"We have always known that NSAIDs can cause potentially deadly stomach
complications, but the extent of the impact on the small intestine was
largely unknown until now," said David Graham, MD, lead study author.
"The introduction of video capsule endoscopy gave us an opportunity to
examine the small intestine and learn that NSAIDs can cause severe
damage to this organ."
Everyday more than 30 million people take over-the-counter and
prescription NSAIDs for pain relief, headaches and arthritis. Currently,
there are about 20 NSAIDs available by prescription only. Many,
including ibuprofen, naproxen, aspirin and ketoprofen are available over
the counter.* Although NSAIDs and aspirin provide great benefit in terms
of pain relief and cardioprotective effects, there is an increased risk
of gastrointestinal complications ranging from stomach pain to ulcers.
Moreover, these drugs are responsible for severe and potentially deadly
gastrointestinal problems. Each year, the side effects of long-term
NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths. More
people die each year from NSAIDs-related complications than from AIDS
and cervical cancer in the United States.
This study analyzed 43 generally healthy patients, including those who
use NSAIDs daily for relief of osteoarthritis, rheumatoid arthritis or
non-specific arthritis, and a control group who did not use NSAIDs or
aspirin for their arthritis symptoms. Results show that 71 percent of
those who were exposed to NSAIDs for more than 90 days had visible
injury to their small intestine. Injury in these people ranged from
small erosions to severe ulcers. Symptoms of dyspepsia (indigestion)
associated with NSAID use are common in those who use these drugs long-term.
Study authors are hopeful that the use of video capsule endoscopy will
allow future researchers to determine how often dyspepsia symptoms
originate from small intestine injury and whether NSAID-associated small
intestine damage causing anemia and leakage of blood proteins
(hypoalbuminemia) can be attributed to specific findings visible by
capsule endoscopy.
"Diseases of the small intestine contribute significantly to ill-health
and often go undetected or misdiagnosed," said Graham. "We hope further
studies will determine the clinical significance of our findings which
show that extensive NSAID-related damage to the small intestine occurs
more frequently than previously reported."
In 2003, the AGA launched the R.E.D.U.C.E. (Risk Education to Decrease
Ulcer Complications and Their Effects from NSAIDs) Campaign to help
explain the potentially harmful effects of NSAIDs and how Americans can
lower their risk for serious gastrointestinal problems.
Researchers at the Michael E. DeBakey VA Medical Center and Baylor
College of Medicine in Houston conducted a study to determine whether
video capsule endoscopy can detect NSAID-associated small intestinal
injury in people who have used NSAIDs continuously for more than three
months. The study included 43 patients, ranging in age from 22 to 66,
who took NSAIDs daily for varying types of arthritis, and a control
group. Study participants were monitored for seven hours using the video
capsule endoscopy system, Given Diagnostic Imaging System manufactured
by Given Imaging, LTD. Video capsules were supplied by Given Imaging,
LTD, but they had no input into study design or analysis. The Department
of Veterans Affairs Office of Research and Development, Medical Research
Service is the lead funding institution on this study.
About the AGA
The American Gastroenterological Association (AGA) is dedicated to the
mission of advancing the science and practice of gastroenterology.
Founded in 1897, the AGA is the oldest medical-specialty society in the
United States. The AGA's 14,000 members include physicians and
scientists who research, diagnose and treat disorders of the
gastrointestinal tract and liver. On a monthly basis, the AGA publishes
two highly respected journals, Gastroenterology and Clinical
Gastroenterology and Hepatology. The AGA's annual meeting is Digestive
Disease Week, which is held each May and is the largest international
gathering of physicians, researchers and academics in the fields of
gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
About Clinical Gastroenterology and Hepatology
The mission of Clinical Gastroenterology and Hepatology is to provide
readers with a broad spectrum of themes in clinical gastroenterology and
hepatology. This monthly peer-reviewed journal includes original
articles as well as scholarly reviews, with the goal that all articles
published will be immediately relevant to the practice of
gastroenterology and hepatology.
* Acetaminophen (Tylenol) is not in the class of non-steroidal
anti-inflammatory drugs.