IBUPROFEN or aspirin could worsen symptoms of certain diseases if you take them regularly, scientists warn.
Popping large and frequent quantities of commonly used non-steroidal anti-inflammatory drugs (NSAIDs) can mess up the balance of your gut microbiota, researchers at Semmelweis University have said.
This is the community of bacteria, viruses, fungi and other microorganisms that live in your intestines, which are essential for your body’s healthy functioning.
NSAIDs are among the world’s most used medications, with over 30 million people taking them daily, according to the Hungarian researchers.
They include drugs that contain ibuprofen or acetylsalicylic acid – also known as aspirin.
But taking these drugs could can cause dysbiosis, messing up the delicate balance of bacteria in the gut, according to a study published in the journal Pharmacology & Therapeutics.
They can also cause symptoms like abdominal pain, diarrhoea, or anaemia.
In rare cases, these common pills can lead to bowel perforation – a hole in the wall of the intestine or colon.
“We have long known that excessive use of non-steroidal anti-inflammatory drugs can disrupt the balance of the gut microbiota,” Dr Zoltán Zádori, leader of the Gastrointestinal Research Group at the Department of Pharmacology and Pharmacotherapy at Semmelweis University, explained.
“We are now looking for the underlying mechanisms, which are only partially understood.”
The study team noted similarities between gut microbiome imbalances associated with certain disease and those caused by taking NSAIDs.
Diseases such as chronic joint inflammation affecting the spine and limbs or rheumatoid arthritis are associated with an imbalance in the gut microbiota and an overgrowth of certain bacteria, Dr Zádori explained.
In fact, these bacteria are linked to the development and worsening of the diseases, he noted.
“We found that these bacterial deviations are similar to those caused by NSAIDs,” the study author explained.
“This raises the possibility that drug-induced gut dysbiosis could worsen the underlying diseases and limit the therapeutic effect of non-steroidal anti-inflammatory drugs in the long run.”
However, seeing as these processes all interact, it’s difficult to identify which precedes the other.
Dr Zádori explained, we currently assume that the NSAID-induced dysbiosis is behind things like “inflammation of the intestinal mucosa, changes in the pH or motor activity of the intestines, or changes in the bile acid composition”.
But he said: “It’s also possible that the NSAIDs’ antibacterial properties directly disrupt the balance of the gut microbiota.
“These processes are closely linked, so it’s difficult to determine which caused which.
“For example, reduced bile function can lead to an overgrowth of intestinal bacteria. At the same time, dysbiosis can also change the quantity of certain bile acids,” Dr Zádori added.
As your gut microbiome plays a fundamental role in multiple processes in your body – balancing sugar and energy levels, bolstering your immune system, and regulating activity in your intestinal wall – an imbalance in the community of bacteria and viruses can contribute to the development of various diseases, researchers said.
This can include conditions like irritable bowel syndrome (IBS), hormonal disorders and cardiovascular, autoimmune, and psychiatric diseases, according to the scientists.
Dr Zádori said there was no one-size-fits-all rule when it comes to how many NSAIDs you can take while ensuring your gut remains healthy.
How sensitive you are to the pills will vary, partly because the composition of your gut microbiota composition depends on several other factors, including your age, lifestyle and health status.
Aside from NSAID use, following a healthy diet and exercising can be important for ensuring a healthy balance of bacteria in your gut.
The Hungarian researchers said they are now looking into ways of counteracting or mitigating the harmful effects of NSAIDs on the gut.
Taking too much ibuprofen has previously been linked to stomach ulcers, fertility issues, adverse heart reactions and even blood clots.
And while taking aspirin on the daily can can help prevent heart attacks and strokes in people who are at higher risk of having them, research has shown that regularly popping the pills can increase your risk of developing anaemia.
The painkiller has also been linked to an increased risk of deadly brain bleeds.
Ibuprofen: What is the recommended dosage?
MAKE sure you take ibuprofen as directed on the label or leaflet, or as instructed by a health professional.
How much you can take depends on your age, the type of ibuprofen you’re taking and how strong it is. For example:
Ibuprofen for adults
Adults can usually take one or two tablets (200mg) every four to six hours but shouldn’t take more than 1,200mg (6 x 200mg) tablets in the space of 24 hours.
Ideally, pregnant women shouldn’t take ibuprofen unless a doctor recommends it.
Ibuprofen for children under 16
Children under may need to take a lower dose, depending on their age; check the packet or leaflet, or ask a pharmacist or doctor for advice.
How long do they take to work?
The painkilling effect of ibuprofen begins soon after a dose is taken, but the anti-inflammatory effect can sometimes take up to 3 weeks to get the best results.
Ibuprofen shouldn’t be used to treat conditions that are mainly related to inflammation.
Don’t take more than the recommended dose if it isn’t relieving your symptoms.
What is it used for?
Ibuprofen is a painkiller available over the counter without a prescription.
It’s one of a group of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs) and can be used to:
- Ease mild to moderate pain – such as toothache, migraine and period pain
- Control a fever (high temperature) – for example, when someone has the flu (influenza)
- Ease pain and inflammation (redness and swelling) caused by conditions that affect the joints, bones and muscles – such as rheumatoid arthritis and osteoarthritis
- Ease pain and swelling caused by sprains and strains – such as sports injuries