She awoke suddenly at three in the morning.
The pain in her stomach was intense. Her body felt like it was on fire.
What seemed like severe gas didn't let up after she tried all her usual tricks. So U.S. Rep. Debbie Dingell made her way to George Washington University Hospital later that day.
Within hours of arriving, she was rushed into emergency surgery. She had a stomach ulcer, known medically as a peptic ulcer. But it was so deep that it ate a hole through her stomach wall. A so-called "perforated" peptic ulcer like Debbie's is a serious medical condition. Depending on one's age, a peptic ulcer can kill up to half of the folks who experience it.
As for the culprit behind her life-threatening diagnosis, it was something that she never would've guessed: ibuprofen.
Dingell had been taking 1,600 mg of ibuprofen daily for about four months. She had thought it was perfectly safe... After all, she had turned down the stronger prescription drugs, opting for this over-the-counter stuff to manage her pain after jaw surgery.
But she had no idea that regularly taking high doses of this common painkiller could land her in the ER. Even scarier, she didn't notice any symptoms before that early morning pain. As Dingell told the Washington Post:
We think if we're taking over-the-counter medicines and we're not feeling anything, we're okay. I didn't know I had an ulcer. I had no stomach pain before this.
So, folks, this is a warning to you...
If you're throwing back ibuprofen – like Motrin or Advil – regularly, you're risking serious health problems.
Ibuprofen has been around for more than 60 years. Its pain-relieving potential was realized in the 1960s when Dr. Stewart Adams – one of the drug's developers – dosed himself with 600 mg one morning, effectively curing a hangover before giving an important speech.
It's a nonsteroidal anti-inflammatory drug ("NSAID") that relieves pain and swelling by blocking the production of inflammation-causing chemicals in your body.
But sometimes, inflammation serves an important purpose... It's your immune system's response to an injury or infection.
So this type of short-term inflammation is helpful... It signals the body to get to work on fixing the problem. (On the other hand, long-term or chronic inflammation is harmful and damages our cells – a topic we've written extensively about.)
Today, roughly 20,000 tons of ibuprofen are manufactured under various brand names worldwide each year.
Unfortunately, plenty of people think it's harmless and pop tons of these pills... In a 2018 survey of roughly 1,300 people who take NSAIDs, 15% reported taking more than the maximum daily dose.
In addition to being one of the most common causes of peptic ulcers when used long term, as Dingell unfortunately found out, studies show ibuprofen also puts folks at risk for heart problems... and even chronic pain.
A 2017 study published in the British Medical Journal reviewed health data from nearly 450,000 adults to examine the relationship between NSAID use and heart attacks. The researchers found that folks currently taking ibuprofen or other NSAIDs had a 20% to 50% increased risk of having a heart attack compared with people not taking NSAIDs.
The American Geriatrics Society even ramped up its NSAIDs warning in the 2019 update to its list of potentially harmful medications (called the Beers Criteria). The group strongly recommends that seniors with symptomatic heart failure steer clear of NSAIDs. And it said that even those with their heart failure under control should take them with caution.
Finally, a new study published in May suggests that short-term use of NSAIDs for sudden ("acute") pain and inflammation may even put folks at a higher risk of developing chronic pain.
A team of researchers examined this idea in three phases. First, they studied the underlying mechanisms of pain that transitioned from acute to chronic in 98 patients with acute lower-back pain. They looked for clues of inflammation in the participants' blood cells at the start of the study and repeated the test three months later.
As it turned out, the group of patients whose pain went away during the experiment had inflammation biomarkers in their blood that spiked in number and then dropped off at their follow-up visit.
In contrast, the folks who developed chronic pain did not experience this same drop-off in the number of inflammation biomarkers. Their inflammation stayed high... suggesting that the initial bout of inflammation was somehow key in resolving people's pain (as I mentioned earlier).
But the team wanted to know more... so they repeated this study with mice. They found that the mice who received an anti-inflammatory drug early on experienced pain for 10 times longer than the mice that didn't receive the drug. In other words, the anti-inflammatory drug prevented pain recovery for the mice.
This happened because the drug impacted a type of immune cell – called a neutrophil –which responds to inflammation and plays a vital role in resolving pain. Without the neutrophils doing their intended job, the inflammation and pain could not be resolved as quickly.
In the final leg of the study, the team looked at existing data on thousands of folks with acute back pain using information from the UK Biobank. They observed that people who took anti-inflammatory drugs were more likely to experience pain two to 10 years later.
Now, taking ibuprofen once in a while to alleviate a headache or reduce a fever is fine. But if you find yourself slurping them down almost daily to ease chronic pain or inflammation, I'd urge you to stop.
Instead, do what I do... The best course of action to stay healthy – and manage your pain and inflammation – is through things like taking regular walks (20 minutes or more a day) and doing yoga... removing sugary, processed foods from your diet... and managing your mental health through meditation.
What We're Reading...
- Read more about Dingell's experience.
- Something different: Ancient Maya cities could be poisonous to today's archaeologists.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
October 4, 2022