NSAID or COX-2 inhibitors and Colitis

mle_ii · Post by **mle_ii** » Thu Dec 07, 2006 3:06 pm

This study appears to demonstrate why taking ibuprophen or other NSAID is bad for us. Reading this it sounds like though it isn't a cause it can lead to limited healing in intestinal damage.

Healing Impairment Effect of Cyclooxygenase Inhibitors on Dextran Sulfate Sodium-Induced Colitis in Rats.
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

We examined the effects of various cyclooxygenase (COX) inhibitors on the healing of colonic lesions induced by dextran sulfate sodium (DSS) in the rat. Colonic lesions were induced by 2.5% DSS in the drinking water for 7 days, and then the animals were fed with tap water for subsequent 7 days. Indomethacin (a nonselective COX inhibitor), SC-560 (a selective COX-1 inhibitor), or rofecoxib (a selective COX-2 inhibitor) was given orally twice daily after termination of the DSS treatment. DSS treatment caused severe colonic lesions with a decrease in body weight gain and colon length as well as an increase in myeloperoxidase activity and thiobarbituric acid reactant levels. The severity of colitis gradually reduced, with an improvement of morphological and histological alterations. Daily administration of indomethacin and rofecoxib significantly delayed the healing of colitis with deleterious influences on histological restitution as well as mucosal inflammation, while SC-560 had no effect. Although COX-1 mRNA was expressed in the colon without much alteration during the test period, the expression of COX-2 was upregulated with a peak on day 3 and decreased thereafter. The mucosal prostaglandin E(2) content in the colon showed a biphasic change, in parallel with that of the COX-2 expression. The increased prostaglandin E(2) production in the injured mucosa was attenuated by indomethacin and rofecoxib, but not by SC-560. These results suggest that endogenous prostaglandins produced by COX-2 play an important role in the healing of DSS-induced colonic lesions. Caution should be paid to the use of selective COX-2 inhibitors as well as nonsteroidal anti-inflammatory drugs in patients with colitis. Copyright (c) 2006 S. Karger AG, Basel.

Liz · Post by **Liz** » Thu Dec 07, 2006 3:18 pm

I was told that my CC could have been influenced by various NSAIDS I had been subscribed for years. In fact I know one of them 'Orudis' would result in severe abdominal pain & D a short time later. That is why my rheumatologist at the time was happy to be able to subscribe 'Celebrex' which I have been taking ever since with much better result.

Liz

kate_ce1995 · Post by **kate_ce1995** » Thu Dec 07, 2006 3:39 pm

This is really interesting. Isn't Celebrex one of the Cox-2 inhibitors? I have some samples of that at home, but haven't been brave enough to take it.

A little story, that triggered in my mind when reading this.

I started having my "anxiety" symptoms at a time when I was given indomethacin for my bad ankle (had a bone chip, had been in a lot of pain, found out I had a "defect" and corisone shot hadn't worked...indomethacin was the next step).

Very sick several months later, was probably taking ibuprofen like crazy between the ankle and the menstrual crap.

A year and a half later, I get MC. 8 months after the symptoms start, I get diagnosis and self treat by stopping ibuprofen use.

Took Vioxx for a while until it stopped working...forget the timing...either a year and a half or 6 months. Rotated to Naproxen. Both of these taken for cramps only. Tylenol for headaches.

I'm going to fast forward to recently. I've been feeling poorly. I had drifted back in the last year to taking ibuprofen as a pain reliever of choice after successfully taking it during my hysterectomy recovery without bowel problems. In the last couple of weeks, I have renewed my efforts to not take ibuprofen. And while I still feel bad from time to time (gluten?) I do not have the major indigestion that I was having a month ago.

My nutritionist talked a little about the whole gut permeability thing (which I admit I haven't read as much on as I should) and said, that if this is what is going on, one can feel poorly (achy, fluish etc) because the body is fighting the stuff leaking through.

Anyone see where I'm going here? Maybe I had over the last year, re-injured my gut through NSAID use, and the day finally arrived when it started affecting me...add in there the possible damage from gluten. Maybe my recent symptoms are related to that (and I'm sure the stress ain't helping) and with time, my gut will re-heal (which I hope it's already doing!).

Katy

Post by **tex** » Thu Dec 07, 2006 7:27 pm

Hi Katy,

Yep, Celebrex is a Cox-2 type inhibitor.

Yes, I see where you're going, and I'm pretty sure that you you're on the right track to suspect ibuprofen. I apologize for not realizing that it might be your problem. I remember when you mentioned that you were taking it again, and at the time I thought to myself, "well, I guess she knows what she's doing, or she wouldn't be doing it", and then I promptly forgot about it.

You've done some good detective work.

Tex

Beth · Post by **Beth** » Thu Dec 14, 2006 12:44 am

I'm a bit at a loss here to know what to do about the whole NSAIDS. I get migraines on a regular basis - seems like I've been getting them twice a week recently. Since I've been on this board again, I've been trying very hard to stay away from ibuprofen. A few nights ago, I could tell a migraine was coming on from the aura I get in my eye, and so I took some four tylenol right away. It did absolutely nothing. That was the worst migraine I've had in quite a while - I almost thought I was going to vomit it was so bad. So, I just got a migraine about an hour ago, and as soon as I saw the aura, I took four ibuprofen. I just didn't want to go through that kind of pain again - because it lasts for at least 24 hours. If I can catch my migraine with ibuprofen as soon as I get the aura, I can get rid of the pain. If not, I'm in agonizing pain. I also can't take any of those Rx migraine medications because of another medication I'm on. Am I setting myself up for increased problems? I'm pretty sure that I got MC from taking a lot of ibuprofen after I injured my back a few years ago. Do others of you get migraines? And what do you do to treat them?

Thanks!

Liz · Post by **Liz** » Thu Dec 14, 2006 4:23 am

Hello Beth
Like you, I used to get an aura before a migraine developed. Frightened the daylights out of me the first time it happened. If I looked at something or someone, all I could see was a blur & flashes. I was at work & serving someone & I could not see what I was doing. I was convinced that I had a brain tumour or something until a girl I worked with told me to see my doctor as it was probably a migraine as she had a similar experience.

That was many years ago & I nearly went mad with them in my child bearing years, especially when pregnant. I also use to black out & not remember periods of time which freaked me out when I had babies & young children to care for. The headaches were horrific & sometimes lasted for up to four days. Could not bear light of any kind & you could not touch my head. It felt as though it was bruised. I don't remember the drug that I was prescribed to take as soon as I got the aura. It was a little white pill with a silver triangle on it. Fortunately I have not had anything like that for quite a few, probably about 30, years ( touch wood) so I suspect that it was hormone related.

Love

Liz

kate_ce1995 · Post by **kate_ce1995** » Thu Dec 14, 2006 6:12 am

Beth,

Have you tried caffine? I used to work with someone who would get the aura thing and would immediately run to Dunkin Donuts and get a coffee. 9 times out of 10 she said it would prevent the migraine from getting worse.

I get horrible headaches sometimes, but I don't think they count as migrains. Although when I was having nausea several years ago from the endometriosis, and I was getting lightheaded and feeling like I was going to pass out, the neurologist said I was having headacheless migraines.

Katy

Post by **tex** » Thu Dec 14, 2006 8:35 am

Beth,

For Tylenol to work effectively, you absolutely have to take it with, or immediately after a meal, otherwise it will not work for most people. Also, eat an apple immediately after you take it, if you have one available - the malic acid in the apple will help it to activate.

By doing it this way, and taking it before the headache/migraine really gets going, I get very good results with Tylenol.

Tex

Beth · Post by **Beth** » Thu Dec 14, 2006 9:59 am

So, you get migraines, too, Wayne? I'll try eating something the next time, but if my migraines keep getting really bad the way they did the other night, I'm definitely going to want to keeping taking ibuprofen. How much damage am I doing if I continue to take that form of pain killer? Also, I know that caffeine is supposed to help, but when I get a migraine at 12:30 at night, the last thing I want to do is pump caffeine into me. I'll try it during the day, though.

Thanks,
Beth

mle_ii · Post by **mle_ii** » Thu Dec 14, 2006 11:58 am

What is the diagnosis for your migraines? What has been tested? Have you been tested for any vitamin/mineral deficency or a water imbalance? Hormonal imbalance? Diabetes? Is there any pattern to your migraines? Like time of day, after eating, drinking, after a certain activity, wearing glasses, wearing contacts, certain supplements/medicines? Are you taking any steroids or stopped taking any steroids?

I hate to say it, but I can see how ibuprofen and other NSAIDs could keep you in a vicious cycle of migraines. In fact I don't even like to see healthy people taking them either given the things I've learned.

Beyond the normal pain killers here are some things to try:
Removing common allergens. Duh. ;)
Drinking more water, drinking less water.
Getting more sodium in the diet, taking the sodium out of the diet.
Same with potasium.
Some supplements, medicines can have the side effect of migraines, so removing some might help.
Removing MSG and sulfites from the diet.

Here are some supplements that might help:
Amino Acids - Lysine, 5-HTP, Tryptophan
Hormone - Seratonin
Herbs - Feverfew, Peppermint, Catnip (yes, catnip), Chamomile, Ginkgo biloba, Lavender, Dong quai (Angelica sinensis), Devil's claw, Mullein, Rhodiola, Noni (Morinda Citrifolia)
Vitamins - A, B2 (riboflavin), B3 (niacin), B9 (folic acid), Bx (paba)

Here's a good site for more info on some of these supplements:
http://www.vitamins-supplements.org/

HTH
Mike

Beth · Post by **Beth** » Thu Dec 14, 2006 12:28 pm

Well, Mike, my diagnosis just seems to be classic migraine. A few years ago, they thought I had an aneurism, and then they said, "Oops, we misread your MRI - there's nothing wrong." So, it's just a simple migraine. However, I'm going to see my naturopath again on Monday, and she'll have a number of test results to go over with me then. Maybe I'll have some answers after that. In the meantime, no there's no pattern to my migraines. They just appear at their own whim. I feel like a wreck!

kate_ce1995 · Post by **kate_ce1995** » Thu Dec 14, 2006 1:52 pm

Beth, I took NSAIDs for cramps and headaches, but no where near every day. It was enough to cause my gut problems. I truely believe that it is what triggered my MC. Within a month of eliminating ibuprofen the D went away. I did got to Vioxx at that point because Tylenol sure as heck didn't do squat for the cramps.

Katy

Liz · Post by **Liz** » Thu Dec 14, 2006 2:22 pm

Beth, chocolate was a trigger for my migraines as I remember. Fortunately I can now eat as much as I like with no ill effect except of course it would make me fat.

NSAIDS have definately been a factor in causing my CC but you are sort of between the devil & the deep blue sea aren't you?

Found this website which could be of benefit to you.
http://www.emedicinehealth.com/causes_a ... cle_em.htm

Looking at the treatment drug list I remembered that the drug that I was prescribed was 'Ergot'
this is interesting - "Combination drugs like butalbital-acetaminophen-caffeine (Fioricet), butalbital-aspirin-caffeine (Fiorinal), or acetaminophen with codeine (Tylenol With Codeine) are general painkillers in the narcotic class. They can help relieve any kind of pain to some degree, whereas the triptans, ergotamines, and Midrin are used specifically for headaches and do not help relieve arthritis, back pain, or menstrual cramps. "

So maybe you could try something like the ones listed. I don't think that NSAIDS are suggested as a remedy.

Good luck - I hope you get some relief soon.

Love

Liz

Beth · Post by **Beth** » Thu Dec 14, 2006 3:46 pm

Thanks for the link to this site, Liz. It's quite interesting. If I were eating chocolate or drinking wine, I might say that those two thing were triggers, especially because I love chocolate. But I haven't eaten any for quite some time now, nor have I drunk any wine in quite awhile, either, so I don't think that's it. What I'm most interested in, however, is what ibuprofen can do to my body right now. Does anyone know if I take it just for migraines - i.e. no more than 1600 mg/week whether I can continue to damage my body? In other words, is the D and the cramping I'm experiencing today most likely from the ibuprofen I took last night? Mike, you said you worried about anyone taking NSAIDs - I'm curious about your reasons. Can you elaborate?

Thanks,
Beth

Liz · Post by **Liz** » Thu Dec 14, 2006 4:08 pm

Hi Beth

What I was suggesting was that there are drugs other that Ibuprofen that could be of benefit to you without the side effects of NSAIDS. You are obviously worried about it so maybe you could talk to your doctor about triptans or the like as an alternative.

Love

Liz