Navigating NSAIDs and Chronic Pain
Many of the clients I work with suffer not only with chonic gut health issues but also from chronic pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) often become go-to options, they’re readily prescribed, available over the supermarket and normalised with marketing campaigns about getting on with life. However, a deeper understanding of the implications of NSAID use on gut health reveals there’s a lot more going on when you swallow that pill. Numerous studies have highlighted the concerning link between NSAIDs and gastrointestinal complications, underscoring the importance of holistic approaches to pain management and education around ongoing dependence on NSAID use.
NSAIDs like ibuprofen and paracetamol damage the gut and liver through distinct mechanisms. Ibuprofen inhibits the enzyme cyclooxygenase (COX), compromising gastric mucosal integrity, (the critical mucosa which protects the gut lining and where our bacteria forage). This process has the potential to cause ulcers and bleeding, increasing the likelihood of gastritis and Inflammatory Bowel Disease (IBD). Paracetamol which is metabolised in the liver, can produce toxic metabolites that overwhelm the liver detoxification pathways, resulting in hepatotoxicity. Studies, including research in the Journal of Clinical Gastroenterology and the American Journal of Medicine, demonstrate that NSAID-induced gastrointestinal damage can occur even at low doses and short durations, such as taking Ibuprofen for monthly period pains, or headaches. In contrast, paracetamol hepatotoxicity is dose-dependent and may occur with prolonged use.
While NSAIDs may provide temporary relief from pain, their impact on gut health is evident in my clinical practice. Often my clients talk about a time they had an injury or surgery and ever sicne that recovery they’ve encountered problems. Naturopathic practitioners, such as myself advocate for a comprehensive approach to pain management that minimizes reliance on NSAIDs and prioritises gut health. I’m not saying it’s a zero tolerance policy for these medications. They have their place and often mean someone in pain can get the rest they need to recover. My focus is on education and offering options that support your best outcomes when it comes to navigating chronic pain. Speaking with your preferred practitioner about strategies to get to the root cause of your pain and find alternative treatments may be as simple as booking an appointment.
Meanwhile, if you’re concerned about the potential damage you’ve done, and perhaps are still doing there are options you can consider. Zinc carnosine has emerged as promising therapeutic options for protecting the gastrointestinal mucosa. Those who have used Ibuprofen regularly, or recently should investigate this. Zinc carnosine, a compound consisting of zinc and L-carnosine, it is not easily absorbed from the gastrointestinal tract, instead, it remains in the gut, and has demonstrated mucosal protective effects which may help enhance the integrity of the gastric lining. Research published in the World Journal of Gastroenterology suggests that zinc carnosine supplementation can support mucosal healing and mitigate NSAID-induced gastrointestinal damage! What a relief.
In clinic addressing chronic pain involves not only symptom management but also prioritising overall health and well-being, in my clinic, this often centres on gut health. Holistic pain management strategies that focus on supporting the gut microbiome and reducing inflammation offer promising alternatives to NSAIDs.
If you’re navigating chronic pain and have been using Ibuprofen or Paracetamol to get through your day, it’s time we set up a strategy for both your pain management and your gut health.
