Such is also the case for naproxen, another non-steroidal anti-inflammatory (NSAID) drug used to relieve pain and cut down swelling, available both over-the-counter in lower doses, and by prescription in higher strengths.
The same goes for aspirin, another pain-reducer and inflammation-halver, which also acts as a blood thinner to prevent harmful clotting. These popular pills are also heavily relied upon to tackle the symptoms arthritis – a condition causing pain, stiffness and swelling in the joints.
But according to the UK-based GP, this can prove a rather risky move, given that these drugs have been known to inflict both ulceration and bleeding onto some patients – especially those who take them regular, or those suffering with arthritis.
“Bleeding from the stomach and upper gut is a dangerous condition that, according to an audit led by a team from the University of Oxford, results in at least 60,000 hospital admissions a year,” Mr Porter explained. “About one in ten of those affected never return home.”
Evidencing his assertion, the medic quoted the findings of a report published in the health journal Gut some time ago, comparing the outcomes between patients from 2007 and from 2022, revealing how many people admitted to hospital enduring bleeds were taking any of these types of medication.
More specifically, Porter was hoping to uncover whether these such ibuprofen, naproxen or aspirin could ’cause or aggravate the problem’.
Speaking to The Times, he also opened up on the damning results, having found that just less than 50 percent of patients analysed were on some form of medication that was exacerbating bleeding in their stomachs.
“And one in 14 was taking a non-steroidal anti-inflammatory – drugs such as ibuprofen, naproxen or normal-dose aspirin used to treat pain and arthritis — which can cause ulceration and bleeding,” Dr Porter continued.
“I would hope that most people taking drugs such as low-dose aspirin and anticoagulants to reduce their risk of stroke, heart attack and blood clots will be aware that these benefits have to be balanced against the risk of bleeding.
“However, too few people taking NSAIDs realise quite how dangerous they can be to some. NSAIDs account for about a third of all NHS hospital admissions caused by adverse drug reactions, which in turn account for about one in five hospital beds.”
He went on to warn: “And it is not just bleeding from the gut — NSAIDs can trigger heart attacks, strokes and kidney damage.”
Putting a pin in arthritis for a minute, Dr Porter added that many people who suffer from general stomach discomfort often find that their symtoms are made worse by these types of medication.
“Anyone prone to indigestion or heartburn will know that even an occasional over-the-counter ibuprofen and aspirin can aggravate their symptoms, but if taken long term they can do much worse,” he added.
“The same mechanism of action (prostaglandin inhibition) that helps most NSAIDs to ease aches and pains weakens the stomach’s natural defence against its own gastric juices, leading to irritation, ulceration, bleeding and even perforation.
Dr Porter added that, as should be the case with all medications, the real day-to-day benefits of a drug should be weighed up by a patient considering taking it, against its potential risks.
“These include anyone on low-dose aspirin (and equivalents such as clopidogrel) or anticoagulants such as warfarin and apixaban, those prone to indigestion or heartburn and/or who have a history of stomach or duodenal ulcers, and people with heart failure and chronic kidney disease,” he continued.
“And anyone over 65 who is not on accompanying gastroprotection such as omeprazole.”