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Painkillers Damage Intestine, U.S. Expert Says
Painkillers Damage Intestine, U.S. Expert Says -- Posted by Roman Bystrianyk on 01-04-05 04:59
http://www.healthsentinel.com/news.php?event=news_print_list_item&id=515
Maggie Fox, "Painkillers Damage Intestine, U.S. Expert Says", Reuters
UK, January 3, 2005,
Link:
http://www.reuters.co.uk/newsArticle.jhtml;jsessionid=GB5EERVIGDCFQCRBAELCFEY?type=healthNews&storyID=7226437
More than 70 percent of patients who took painkillers such as ibuprofen
for more than three months suffered damage to their small intestines,
U.S. researchers reported on Monday.
The study is yet another blow to patients trying to find ways to treat
arthritis pain, after reports that the most advanced drugs, called
COX-2 inhibitors, can raise the risk of heart death.
Dr. David Y. Graham of the Baylor College of Medicine in Houston and
colleagues studied 21 patients taking a range of drugs called
non-steroidal anti-inflammatory drugs, or NSAIDS. They compared them to
20 patients taking either acetaminophen, an unrelated painkiller, or
nothing.
"Small-bowel injury was seen in 71 percent of NSAID users compared with
10 percent of controls," they wrote in Monday's issue of the journal
Clinical Gastroenterology and Hepatology.
"We have always known that NSAIDs can cause potentially deadly stomach
complications, but the extent of the impact on the small intestine was
largely unknown until now," Graham added.
Arthritis pain is incurable but can be treated with a range of drugs,
including NSAIDS such as aspirin, ibuprofen or naproxen; acetaminophen;
or the newer drugs called COX-2 inhibitors.
NSAIDS work very well but damage the stomach and intestine. They are
blamed for 16,500 deaths a year in the United States alone, Graham
said.
BENEFIT VS. RISK
"Anybody who takes aspirin or (other) NSAIDS for a year has a 1 to 4
percent risk of serious gastrointestinal complications," Graham said in
a telephone interview.
"If the drugs didn't have such benefits, we'd have taken them off the
market some time ago."
Acetaminophen, sold generically and also under the brand name Tylenol,
does not work for many patients, Graham said.
The COX-2s were designed specifically to overcome the deadly
side-effects of NSAIDS. But a series of studies has linked them to
heart disease and one, Merck and Co. Inc.'s Vioxx, was pulled from the
market in September.
In December the U.S. Food and Drug Administration issued an advisory
telling doctors to limit their prescribing of other COX-2s, including
Pfizer's Celebrex and Bextra.
And a study published in December indicated that an over-the-counter
NSAID called naproxen might also raise the risk of heart attack and
stroke.
Graham's team used an endoscope in the form of a swallowed camera in a
capsule to examine the intestines of their volunteers. Although people
taking NSAIDs frequently suffer stomach pain or anemia, none of the
volunteers in this study had any symptoms.
"We saw some ulcers and we saw lots of erosions," Graham said.
Some experts have recommended using antacid drugs called proton pump
inhibitors (PPI) to reduce the damaging effects of stomach acid in
NSAID patients. But PPIs do not affect the small intestine, Graham
said.
Instead, he said, an older drug called misoprostol can help protect the
stomach lining.
"It is the only drug approved to reduce the rate of bleeding," Graham
said.
A U.S. government study published last month found that acupuncture can
help to further relieve arthritis pain in the knee in patients getting
more standard treatment.
The American Gastroenterological Association estimates that more than
30 million Americans take over-the-counter or prescription drugs for
headaches and arthritis.
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