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The Effect of NSAIDs on Gastrointestinal Health

Image of NSAIDs Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly bought over-the-counter drugs. Doctors prescribe them often and people use them on themselves, their children, and even their pets to help with pain and fevers. They’ve become a simple remedy for pain relief and all types of ailments, but what are they doing to our bodies?

NSAIDs have been linked to several dangerous conditions like stomach ulcers and liver damage. But these aren’t the only problems that using NSAIDs can cause. 

In this article, we will cover how NSAIDs affect the gastrointestinal system and gut microbiome — and how that can affect the rest of your body leading to some surprising problems. 

What are NSAIDs?

As we mentioned above NSAID stands for a non-steroidal anti-inflammatory drug. Essentially this means that they’re used to tame down the inflammatory process that is associated with inflammation and pain. 

When we feel pain it’s because neurons (nerve cells) in the area we feel pain sends a signal to the brain to let it know something is wrong in that area. So the brain then signals for different cells to go to that area to see what the problem is and try to fix it. In the event of injuries, swelling will happen because of a rush of these cells trying to fix the problem and stabilize the area. 

What NSAIDs do is stop that signal from being sent out. They are used to numb that signaling so that your brain doesn’t realize there is a problem and you can continue about your day. While this allows you to function, it can cause further damage to the area because you aren’t letting it heal properly. 

What do NSAIDs do to your gastrointestinal (GI) tract?

A common side effect of NSAID use is heartburn. While this is often written off as a minor problem (and not a big deal) it is actually a sign that there is damage being done somewhere in your digestive tract. 

When it comes to NSAID use, the mucosal lining of your GI tract is damaged. The mucosal lining is important because it keeps all your good bacteria inside your gut and keeps other things out of your digestive tract that doesn’t belong there. When the mucosal lining becomes damaged it can cause you to feel heartburn — but that is just the beginning. 

This damage — if left untreated — can lead to ulcers and significant damage to your GI tract. 

What do NSAIDs do to your gut microbes specifically?

Your gut microbes live in your mucosal lining. So when that starts to be compromised your gut bacteria are highly affected as well. When the mucosal lining becomes damaged by NSAIDs it becomes permeable. If you think about the NSAIDs as being like an acid that erodes holes into the lining, this is what happens to the intestinal wall. 

This allows your gut bacteria to escape through these holes and float freely throughout your body. While they aren’t dangerous and are actually helpful in your gut, outside of it they’re like any other bacteria and cause a lot of problems. 

Outside of this, NSAIDs were actually shown to affect the balance of your gut microbes and contribute to dysbiosis. NSAIDs are able to stop your good bacteria from reproducing and can kill some of them off. They also have a tendency to feed the bad bacteria which leads to disease and more inflammation.

One study actually found that depending on which type of NSAID you use, it can create a different microbial profile in your gut. This means that if your doctor were to do a fecal test on you they might be able to tell which NSAID you usually use because their profiles are so distinct.

How to protect yourself from NSAID-related GI damage

NSAID damage seems to be worse when people use them often (chronically). If you have arthritis, an injury that never fully healed and bothers you daily, or conditions that make you have chronic pain, you’re likely using NSAIDs more often than you should. 

If this is the case, then looking for alternatives to NSAIDs is an obvious first route. There will be times that you will need them and that is okay. At this point looking for ways to limit the amount of time that you use them is the goal. 

As of now, doctors are prescribing chronic NSAID users with probiotics (to help keep the microbiome in balance) and sometimes rebamipide (a mucosal protective agent). However, probiotics can be dangerous for some populations of people and you may not want to add another medication to your routine. 

Natural Pain-Relief Alternatives 

Brain Holding Onto NsaidsSo if you don’t want to be taking too many NSAIDs or medications you may want to consider what natural remedies are available. Here are our top suggestions for you.

  1. Take care of your gut — your gut controls a majority of your immune system (and therefore your inflammatory response) if you take care of your gut it can help with your pain levels too. Do this by drinking enough water, watching stress levels, sleeping well, and eating healthily.
  2. Get your diet under control — certain foods can increase inflammation (sugar, salt, and unhealthy fats). While others can help to improve inflammation (plant-based foods that are full of polyphenols, prebiotics, postbiotics, and nutrients)
  3. Natural anti-inflammatory agents — peppermint is a great way to reduce inflammation. Drink peppermint tea to help get antioxidants and other properties that reduce inflammation and help your body to repair itself.
  4. Take Atrantil — while Atrantil wasn’t created to be an anti-inflammatory it does have peppermint leaf in it to help reduce inflammation. The other ingredients help it to keep your gut healthy and full of good bacteria. By taking Atrantil you knock two things off this list at one time.
  5. Medical marijuana — if it is legal where you live, medical marijuana has been shown to help people significantly reduce their chronic pain levels

Living with pain day after day is difficult. But putting your health at risk isn’t necessary when there are so many other options out there. Talk to your doctor about trying something outside of pain killers and NSAIDs for your pain to make sure you aren’t putting your health on the line. 

What have you found to help reduce pain levels without NSAID use? Let us know in the comments below!

  1. https://www.nhs.uk/conditions/nsaids/
  2. https://iffgd.org/manage-your-health/diet-and-treatments/nsaids/ 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188723/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426480/#s3title
  5. https://www.sciencedirect.com/science/article/pii/S1198743X15009027
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968020/