Risk Factors For Peptic Ulcers
Not everyone who regularly takes NSAIDs will also need to take medication to protect their stomach. This will mainly depend on your personal risk of developing a peptic ulcer. Peptic ulcers are more likely to develop in people who
- are over the age of 65,
- have had a peptic ulcer in the past,
- take several different painkillers at once for instance, including acetylsalicylic acid for the prevention of complications following a heart attack or stroke,
- take steroids too,
- take a selective serotonin re-uptake inhibitor antidepressant as well as a painkiller.
Younger people who don’t have any risk factors aren’t likely to get peptic ulcers. So they hardly benefit from taking medication to prevent peptic ulcers.
Assessing Your Likelihood Of Developing Gi Side Effects From Nsaids
For some arthritis patients, NSAIDs may not be an option because of other health issues.
Typically, if someone has a history of peptic ulcers, gastrointestinal bleeding, or Barretts esophagus, NSAIDs should be avoided, Dr. Bhana says. Anyone who is on blood thinners or will be undergoing surgery may need to avoid these medications as well, he adds, because the risk of life-threatening bleeding is significantly higher.
Other medications that may increase your risk of bleeding when taken with NSAIDs include low-dose aspirin , selective serotonin reuptake inhibitors such as Prozac and Paxil, and glucocorticoids.
If your doctor determines you shouldnt take oral NSAIDs, he or she may recommend other therapies for pain relief.
There are topical NSAIDs, such as diclofenac, that may be helpful for localized arthritic pain, Dr. Bhana. These have a low rate of systemic absorption and are safer for your stomach.
Non-NSAID analgesics such as acetaminophen may also be an option.
Dark Side Of Pain Relief
- Copy Link URLCopied!
That longtime staple of medicine cabinets, acetaminophen, appears to be under fire. Used to treat headaches, muscle aches and seemingly every other ache Americans have, the drug found most notably in the brand name pain reliever Tylenol has recently been called a potential danger to the millions of people who take it.
But the drug itself hasnt changed. Nor have the number of problems associated with it. The only new element is public attention to its risks.
A Food and Drug Administration advisory committee met late last month to review the actions the agency could take to reduce accidental acetaminophen poisoning. The drug, also found in over-the-counter cold formulas and pain-relieving prescription favorites Vicodin and Percocet, is the most common cause of acute liver failure in the U.S.
In acute liver failure, the organ fails quickly, sometimes in 48 hours, as opposed to the more usual forms of liver failure, caused by disease or alcoholism, which can take years to develop.
Taking too much acetaminophen does not always cause liver failure. In 2008, the California Poison Control System logged 16,352 cases of suspected acetaminophen overdose, according to the agencys executive director, Stuart Heard. Most cases were not serious, but more than 4,000 people were hospitalized. Of those, 156 suffered serious medical outcomes, such as liver transplants, and 14 people died.
Heres a Closer Look at acetaminophen:
What amounts to an overdose?
When Should You Not Take Tylenol
There are times when you should not take Tylenol. Children under the age of 12 should not take more than 5 doses in 24 hours. When you are unsure of the dosage, you should consult a doctor. The correct dose for children is a milligram per dose. When taking Tylenol, you should also avoid other medicines that contain acetaminophen . You should also consult a physician if your child has any of the symptoms listed below.
Although there are no known adverse effects of taking Tylenol, there are certain conditions that can increase the risk of complications. Liver damage and severe skin reactions can occur when you take too much of the drug. In the U.S., it is the leading cause of acute liver failure. In England, it is the leading cause of fatal liver problems in children. If you have a fever or a chronic illness, you should avoid taking Tylenol or other acetaminophen products.
There are several reasons not to take Tylenol. While it is a popular choice for minor pains and inflammation, it is not a good choice for people with liver disease or kidney problems. While Tylenol is generally safe, there are times when it is not. A patient with liver disease or a preexisting medical condition should consult a health care professional before taking any type of medication.
Proton Pump Inhibitors Lower The Risk Of Peptic Ulcers
The proton pump inhibitors used in the studies were lansoprazole , omeprazole and pantoprazole . The studies lasted up to six months. They showed that, compared to a placebo, all of these proton pump inhibitors clearly lowered the risk of getting peptic ulcers:
- Without a proton pump inhibitor, 36 out of 100 people developed an ulcer.
- With a proton pump inhibitor, 14 out of 100 people developed a peptic ulcer.
In other words: Proton pump inhibitors prevented the development of NSAID-related peptic ulcers in 22 out of 100 people.
Proton pump inhibitors may cause headaches, diarrhea, constipation and stomach pain. Only a few people in the studies stopped their treatment early due to side effects.
But it’s not clear whether the long-term use of proton pump inhibitors is safe. It has been observed that hip fractures, spinal fractures and wrist fractures are more common in people over the age of 50 who have taken PPIs in a high dose or for longer than a year.
It is also thought that the long-term use of PPIs might increase the risk of intestinal infections and pulmonary infections or nephritis .
Recommended Reading: How To Find Out If You Have Ulcerative Colitis
What Are The Key Findings
Key findings of Tylenol are the following. More than half of all people who use it report experiencing side effects. The most common side effects are stomach pain, diarrhea, and nausea. People with liver problems should not take Tylenol.
It is not recommended for children under the age of 12. It should be used with caution by people who have had ulcers or bleeding in the stomach, kidney disease, or heart problems. People who take Tylenol regularly should not drink alcohol.
It is important to read the label and follow the directions. It is also important to talk with your doctor about the risks and benefits of taking Tylenol.
Poor Appetite And Inexplicable Weight Loss
Recurrent vomiting may further deteriorate your health by depriving your body of block-building nutrients.
Recommended Reading: Carbohydrate Diet For Ulcerative Colitis
Is It Ok To Take 2 Tylenol Every Day
Yes, It is fine. According to this article in USA Today, there is no research to support the idea that taking an occasional extra dose of Tylenol is harmful. The key is to not take it routinely for your daily headaches. Taking too much Tylenol can actually cause stomach bleeding if you are taking it on a regular basis..
Who Should Use Tylenol
Adults 18 years of age and older have a cough that is non-productive or associated with colds. Tylenol may also be used to temporarily relieve minor aches
and pains, such as headache, toothache, backache, muscle aches, and menstrual cramps. Tylenol is not recommended for children under 12 years of age.
Read Also: What Not To Eat With An Ulcer
How Do Ulcers Develop
NSAID usage isnt the only reason ulcers develop in the stomach or upper area of the small intestine. Another common culprit is a bacterial infection caused by Helicobacter pylori, or H. pylori. And although NSAIDs and H. pylori infection are independent risk factors, Staller said, they can work together to increase a persons chances of developing ulcers.
Dingells case appears to be more directly tied to taking ibuprofen, however. The saga, as she calls it, started months ago, when a bothersome dental implant led to a bone infection in her jaw. After she had jaw surgery in January, the lawmaker, who has been outspoken about the dangers of opioids and narcotics, instead opted to take Motrin for pain relief.
Soon, Dingell said, she was regularly downing 800 mg morning and night, which continued long after the initial surgery. By around March, Dingell said, her doctors started to raise concerns about how much ibuprofen she was taking.
The doctors warned me, she said. They told me that taking it for this long, they wanted to watch me closely, and I thought I was invincible.
Ibuprofen and other pain relievers such as naproxen, or Aleve, reduce your bodys ability to make a layer of mucus that protects the lining of your stomach from gastric acid, said Christian Stevoff, clinical practice director in the division of gastroenterology at Northwestern Universitys Feinberg School of Medicine.
In The Stomach Nsaids Inhibit Cyclooxygenase
In the stomach, COX-1 plays an important role in gastric mucosal protection. NSAID inhibition of COX-1 can diminish this COX-1 mediated protective mechanism. This can lead to GI side effects such as irritation and bleeding.5
Because TYLENOL® does not interfere with COX-1 like NSAIDs, it does not irritate the stomach the way naproxen sodium or even ibuprofen can.1-4
Don’t Miss: Triderma Diabetic Ulcer Defense Healing Cream
What Is The Dosage For Acetaminophen Vs Ibuprofen
- The dose for adults is 325 to 650 mg every 4 hours or 500 mg every 8 hours when using immediate release formulations.
- The dose for extended release caplet is 1300 mg every 8 hours.
- The maximum daily dose is 4 grams.
- The oral dose for a child is based on the childâs age and weight. If less than 12 years old the dosing is 10-15 mg/kg every 6-8 hours not to exceed 2.6 g/day . If older than 12 years of age the dose is 40-60 mg/kg/day every 6 hours not to exceed 3.75 g/day .
- For minor aches, mild to moderate pain, menstrual cramps, and fever, the usual adult dose is 200 or 400 mg every 4 to 6 hours.
- Arthritis is treated with 300 to 800 mg 3 or 4 times daily.
- When under the care of a physician, the maximum dose of ibuprofen is 3.2 g daily. Otherwise, the maximum dose is 1.2 g daily.
- Individuals should not use ibuprofen for more than 10 days for the treatment of pain or more than 3 days for the treatment of a fever unless directed by a physician.
- Children 6 months to 12 years of age usually are given 5-10 mg/kg of ibuprofen every 6-8 hours for the treatment of fever and pain. The maximum dose is 40 mg/kg daily.
- Juvenile arthritis is treated with 20 to 40 mg/kg/day in 3-4 divided doses.
- Ibuprofen should be taken with meals to prevent stomach upset.
Water Is A Key Factor
When you wake up with pain, you may ask can I take Tylenol on an empty stomach. It is important to note that this is different than asking can you eat Tylenol without water. If you decide to chew on Tylenol to increase the absorption rate, you are not supposed to consume the drug with water.
If you search for Tylenol on empty stomach Reddit, you will notice that many people report no serious side effects. This is because acetaminophen empty stomach administration is well tolerated in most people. In fact, some people report enhanced efficacy. In this scenario, we should note what happens when you take Tylenol on an empty stomach.
Recommended Reading: Low Residue Diet For Ulcerative Colitis
H2 Blockers: Effectiveness Depends On Dose
The studies on H2 blockers mainly looked at the drugs famotidine and ranitidine. These studies lasted up to one year. Both drugs were shown to prevent peptic ulcers, but their effectiveness greatly depended on the dose taken. When taken at lower doses, the medications only reduced the risk of duodenal ulcers. When taken at higher doses, they effectively prevented both stomach ulcers and duodenal ulcers:
- Without an H2 blocker, 36 out of 100 people developed an ulcer.
- With an H2 blocker, 15 out of 100 people developed an ulcer.
In other words, higher doses of H2 blockers prevented peptic ulcers in 21 out of 100 people.
The effective doses in the trials were 40 mg twice daily for famotidine and 300 mg twice daily for ranitidine. These medications were also well tolerated at higher doses. Side effects such as headaches, diarrhea or constipation may occur, though.
What Are The Types Of Over
Common OTC pain medications include:
- Acetaminophen: This drug dulls pain receptors in the brain. As a result, you feel less pain.
- Nonsteroidal anti-inflammatory drugs :NSAIDs lower the production of prostaglandins. These hormone-like chemicals irritate nerve endings, causing inflammation and pain. NSAIDs include aspirin compounds , ibuprofen and naproxen sodium .
- Combination: Some pain relievers contain both acetaminophen and aspirin . Certain OTC headache medicines also have caffeine.
- Topical: You apply this pain medication directly to your skin. It comes as a cream, gel, spray or patch. Topical medicines block pain receptors in the brain. They may contain aspirin, lidocaine, capsaicin pepper or other medication. Some topical treatments make the skin feel warmer or cooler. Common brands are Aspercreme® and Ben-Gay®.
Recommended Reading: 8 Foods To Eat During An Ulcerative Colitis Flare
What Are The Side Effects Of Tylenol
Adverse effects are generally similar to those of other NSAIDs and may include:
The most common side effect is gastrointestinal bleeding. The risk is higher in those with a history of ulcers or bleeding, the elderly, and those taking high doses. Other common side effects include headache, loss of appetite, dizziness, drowsiness, heartburn, nausea, and vomiting.
Tylenol is contraindicated in those with a history of asthma or allergic reactions to aspirin.
It should not be used in those with liver disease, bleeding disorders, heart failure, kidney failure, or stroke.
Tylenol is not recommended in the last three months of pregnancy.
How Do You Tell If The Lining Of Your Stomach Is Damaged
With the advancements in technology, it is now possible for doctors to perform endoscopy, which is a non-invasive method of examination of internal body organs. Endoscopy of the gastrointestinal tract is performed by inserting an endoscope into the patients body, passing it through the mouth into the esophagus, stomach, pancreatic duct, duodenum, and so on. The instrument used in the examination is called the endoscope. This instrument is composed of an illuminating system, a camera, and a miniature video camera which are fitted into a tube. The endoscopy of the gastrointestinal tract allows the surgeon to see the various parts of the gastrointestinal tract for diagnostic purposes, treatment, and assessment of the severity of the disease. The camera attached to the endoscope transmits images captured by the camera into a monitor. With this, the doctor is able to have a look at the lining of the stomach. This examination is conducted in an outpatient clinic or your doctors office. Sedation may be necessary to make the patient relax during the examination..
You May Like: Causes Of Bleeding Ulcers In Stomach
Burning Pain In The Abdomen
Persistent burning pain in the abdomen is one of the first signs of a stomach ulcer. The sensation of pain occurs when juices in the stomach, which help in digestion, come into contact with an open sore in the stomach lining.
In most cases, the pain is felt from the breast bone to the navel, and it often worsens during the night. If you skip meals, particularly breakfast, you may also experience this burning sensation in the stomach during the daytime.
If the dull and burning ache of the ulcer often turns into a sharp, stabbing pain, it is a sign that your ulcer is acting up and you need medical help. It could mean that the ulcer has caused a more critical problem like a perforation in the wall of your stomach or intestine, or a blockage in your digestive tract, and it is triggering intense pain.
Read Also: Is Alcohol Bad For Ulcerative Colitis
Why Tylenol Can Be A Better Option:
- #1 Doctor Recommended Pain Relief brand for those with stomach problems.
- TYLENOL® will not upset the stomach the way naproxen sodium , or even Ibuprofen can.
- TYLENOL® can help relieve your pain while being gentle on your stomach.
- TYLENOL® can be taken on an empty stomach.
- TYLENOL® may be a safe over the counter pain reliever for those with a history of stomach bleeding, stomach ulcers, or stomach problems such as heartburn.
- TYLENOL® is not an NSAID. NSAIDs can cause stomach ulcers and an increased risk of severe stomach bleeding.
You May Like: What Is A Good Diet For Ulcers
How Should This Medicine Be Used
Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension , and drops . Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.
Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen.