Do the benefits of aspirin and NSAIDs for your heart outweigh the risks to your gut? Here's advice on how to reduce the risk and what to do if you begin to experience side effects.
Most of the time, over-the-counter and prescription medications are helpful and safe. But sometimes they can cause gastrointestinal side effects. These adverse effects are more likely to occur if you're already at risk for digestive problems or if you don't take the medication exactly as instructed. Fortunately, most of these side effects are not life threatening and disappear soon after the medication is stopped.
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), and ketoprofen (Orudis) cause stomach upset, bleeding in the digestive tract, and ulcers in some people.
NSAIDs have these effects because they disable the stomach's protective mechanisms that shield it from the acidic juices used to digest foods. Older people are most at risk for these NSAID-related stomach problems, since the protective mechanisms operate less well with age. NSAIDs can also cause bleeding in other parts of the body, because they inhibit the blood's ability to clot.
Reducing the Risk of NSAIDs: When taking an NSAID for pain relief, use the safest drugs first. In fact, the first drug to try -- acetaminophen (Tylenol) -- isn't an NSAID at all. If acetaminophen doesn't offer sufficient pain relief, try a nonprescription NSAID such as aspirin, Advil, Motrin, or Aleve. When using these nonprescription NSAIDs, take them with meals and do not exceed the recommended dosage or duration of use listed on the label.
If you need to take a nonprescription pain reliever for longer than 10 days, consult your doctor. When you need to turn to one of these drugs, use the lowest effective dosage, for the shortest time possible. If you are taking an NSAID regularly for pain relief or a daily aspirin to prevent a heart attack or stroke, ask your doctor if you should also take a stomach-protective drug such as sucralfate (Carafate) or a proton pump inhibitor -- esomeprazole (Nexium), lansoprazole (Prevacid), or omeprazole (Prilosec) -- to reduce your risk of ulcers and bleeding.
When NSAID Side Effects Arise: Call your doctor right away if you experience any of the following symptoms of NSAID-related damage: stomach pain; black, tarry, or bloody stools; vomit that contains blood or coffee ground-like material; or weakness, dizziness, chest pain, or shortness of breath. If you're taking aspirin to prevent a heart attack or stroke, don't stop taking it until you speak with your doctor. Stopping aspirin abruptly can actually increase your risk of a heart attack or stroke.
