It comes as a surprise to every patient I bring this up to that non-steroidal anti-inflammatory drugs (NSAIDs) cause anywhere from 16,000-22,000 deaths per year from bleeding ulcers alone.
I usually give this statistic when someone may be nervous about chiropractic care or the safety of chiropractic care. It’s basically the same equivalent as being nervous about flying on a commercial jet under the eyes of the FAA but being OK with bungee jumping off a water tower in Alabama.
These numbers also do not include the monstrous numbers of death caused by NSAIDs’ increased risks of heart attacks, strokes, liver failure and kidney failure. I’m pretty sure most would be absolutely shocked to learn just how dangerous popping a simple over the counter ibuprofen actually is. While these less popular dangerous side effects of NSAIDs are by far more common, the fact remains that most doctors think about the gastrointestinal side effects of NSAIDs more than the other effects.
This is the reason for the creation of the blockbuster class of drugs called the selective COX-2 inhibitors (Vioxx, Celebrex, Bextra). They were supposed to protect the stomach but still achieve the anti-inflammatory effect. So long as you still have your long-term memory intact, you should remember just how well THAT turned out. For those of you showing early signs of lifestyle-related dementia, Vioxx made headlines and was taken to task by the FDA when it was discovered that they knew that Vioxx was causing heart attacks but downplayed the data given to doctors, ultimately leading to Vioxx being pulled off the market.
The ironic part is that, this “GI-protective class” of anti-inflammatories doesn’t even do that very well. Regardless, NSAIDs have known gastrointestinal toxicity. This particular study plants the ultimately irony on this sometimes fatal scenario.
Researchers looked at what might be causing the damage to the lining of the stomach and leading to bleeding ulcers. Their finding? Inflammation.
Yes, the anti-inflammatories are creating their most notorious side effect by the very same mechanism that they are supposed to be stopping. The inflammation in this study came from a compound called TNF-alpha, which is a major driver of inflammation in the body (and the main target of high powered drugs for autoimmune conditions like rheumatoid arthritis and Crohn’s disease).
While this is an animal study, the authors suggest that blocking TNF-alpha with more powerful anti-inflammatories may help protect against the GI related toxicity of the NSAID class of drugs. Brilliant. No wonder our healthcare system is so screwed up.