Ibuprofen, a widely recognised over-the-counter medication, belongs to a class of drugs known as NSAIDs, or nonsteroidal anti-inflammatory drugs.

People commonly use these medications to reduce pain, inflammation, and fever.

These medications inhibit cyclooxygenases (COX) enzymes. These enzymes produce prostaglandins, which play a role in inflammation and pain perception.

While NSAIDs can effectively manage pain and inflammation, they also increase the risk of gastrointestinal issues.

Common NSAIDs

Some of the most well-known NSAIDs include:

  • Ibuprofen: People widely use this over-the-counter medication to relieve pain and reduce inflammation
  • Aspirin (acetylsalicylic acid): While primarily known for its blood-thinning properties, aspirin also acts as an NSAID and is used to relieve mild to moderate pain and reduce inflammation
  • Naproxen: Available both over-the-counter and by prescription, people use naproxen to treat pain and inflammation.
  • Diclofenac: This prescription-strength NSAID is used to relieve pain and inflammation caused by various conditions
  • Celecoxib: Unlike traditional NSAIDs, which inhibit both COX-1 and COX-2 enzymes, celecoxib selectively targets COX-2 and is used to treat pain and inflammation while reducing the risk of gastrointestinal side effects
Adverse effects NSAIDs

The most prevalent adverse effects of NSAIDs are gastrointestinal symptoms, primarily stomach irritation and heartburn.

In severe instances, NSAIDs can irritate the stomach lining, leading to the formation of ulcers, small erosions and gastrointestinal bleeding.

A 2022 study identified potential risks of NSAID use, particularly ibuprofen, in exacerbating gastroesophageal reflux disease symptoms and damaging oesophageal tissue.

Researchers examining the effects of NSAIDs on rabbit oesophageal tissue found that ibuprofen and aspirin inhibited tissue transport functions in a dose-dependent manner.

Specifically, even low doses of ibuprofen in combination with acid had a significant additive effect on tissue disruption. Both in vitro and in vivo experiments showed harmful effects of NSAIDs on the oesophageal epithelium, with ibuprofen demonstrating a more pronounced decrease in tissue potential difference and short-circuited current compared to aspirin.

While a 2008 study aimed to investigate the relationship between NSAID use and gastro-oesophageal reflux disease. Researchers sent a self-administered questionnaire to a representative sample of 10,000 French adults. They found that NSAID use significantly increased the risk of GERD symptoms, such as heartburn and acid regurgitation.

NSAID users had a higher prevalence of GERD symptoms compared to non-users. Researchers identified NSAID use, age, and female gender as independent predictors of GERD symptoms.

The mechanism behind this risk involves the weakening of the lower oesophageal sphincter (LES), allowing stomach acid to flow back into the oesophagus and causing symptoms such as heartburn and regurgitation.

Another 2023 study also highlighted the potential risks associated with NSAID use, particularly in relation to gastrointestinal complications. It found that nearly half of the participants who used NSAIDs experienced gastrointestinal issues, with peptic ulcers being the most common complication.

Diagnosing reflux

Understanding the role of NSAIDs and their potential impact on reflux is important for anyone who regularly uses these medications for pain relief.

Be sure to follow the recommended dosage instructions provided by healthcare professionals or as indicated on the medication packaging to avoid potential adverse effects or overdose.

If you’re experiencing frequent heartburn or acid reflux symptoms while using NSAIDs, it’s wise to take proactive steps to diagnose and manage these symptoms.

You can bring Peptest, an innovative diagnostic tool that helps diagnose reflux disease from the stomach into the oesophagus, larynx, mouth, or airways by detecting pepsin within a saliva sample, into your reflux management plan.

By identifying underlying issues contributing to your symptoms, Peptest can empower you to make informed decisions about your treatment and lifestyle choices.

Further advice on your use of NSAIDs

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