An NHS doctor has issued an alert over common pills which millions of people take every day – but which could lead to a life-threating stomach ulcer. Dr Mark Porter spoke about anti-inflammatories – and explained that very well used pills like ibuprofen can lead to ‘life threatening’ stomach ulcers – and explained the early red flags of how to spot if there’s a problem.
And the commonly taken types such as ibuprofen can in fact increase blood pressure, the risk of heart attacks and strokes, and kidney disease.
Dr Porter wrote in his Times column that ‘tens of thousands’ of people are hospitalised every year – with one in ten dying. About one in ten will develop a stomach or duodenal ulcer at some stage and while most recover with no issues, some, like Radio 2 DJ Steve Wright, never even make it to hospital.
Dr Porter said: “Complications from these peptic ulcers, such as bleeding and perforation, can be life-threatening and hospitalise tens of thousands of people a year in the UK, at least one in ten of whom will never return home. Catastrophic though these “burst” ulcers can be, it’s bleeding that poses the bigger threat nationally because it is far more common.
“In a typical year in the UK about 25,000 people will require admission to hospital because of a bleed from the upper part of their gut, and many of them end up there because of the pills they are taking.” He said the main reason people get the issue is nonsteroidal anti-inflammatories (NSAIDs), the family of drugs that includes aspirin, ibuprofen, diclofenac and naproxen, “taken by millions of people to treat problems such as arthritis and back pain”.
He said that anyone on an NSAID can develop problems like indigestion and heartburn, but the higher the dose and the longer it is taken, the greater the risk of an ulcer or bleed. And he warned: “An average person taking an NSAID is four times as likely to have a bleed from their stomach than a peer who is not taking one. If they are also taking an SSRI-type antidepressant (eg sertraline or citalopram) — as about one in six adults in the UK will at some stage this year — that risk increases to sevenfold. And if you take an NSAID and a steroid (eg prednisolone) it rises to twelvefold.”
Dr Porter said taking acid-suppressing medication such as omeprazole and lansoprazole alongside the NSAID, will help stop it happening. He added: “Some commonly used types, including ibuprofen, increase the risk of stroke and heart attack, and they can all raise blood pressure, cause fluid retention, lead to kidney disease (and failure) and aggravate asthma.
“If you are self-medicating for pain or fever relief, I generally recommend paracetamol rather than ibuprofen or aspirin. It may not work as well in some people, but it is safer (unless in overdose). If you are already on an NSAID prescribed by your doctor, do not take over-the-counter aspirin, which increases the risk of ulceration and exacerbates any subsequent bleeding through its effects on clotting.
“If you are prescribed an NSAID without anything to protect your stomach, do ask the prescriber why. Additionally, if you are on long-term therapy and not taking the acid-suppressing medicine as you are supposed to (some patients don’t see the point), please restart it.”