Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a familiar part of most medicine cabinets. People reach for them to ease headaches, arthritis pain, sore muscles, and fever. They work well for many kinds of discomfort, but they can be hard on the stomach, especially when taken often or in high doses. Understanding why that happens can help you use them more safely.
What NSAIDs are and how they work
Common NSAIDs include ibuprofen, naproxen, and aspirin, all available without a prescription. They ease pain and swelling by blocking certain enzymes the body uses to produce inflammation. The trade-off is that those same enzymes also help the stomach maintain its protective inner lining. When NSAIDs lower that protection, stomach acid can begin to irritate tissue it would normally leave alone.
How they can affect the stomach
For most people, an occasional dose causes no trouble. With regular or high-dose use, however, NSAIDs can produce heartburn, indigestion, nausea, and stomach pain. Over time, they can contribute to gastritis, an inflammation of the stomach lining, and to ulcers that can bleed.
Some people face higher risk than others, including older adults, anyone with a history of ulcers, people who take blood thinners or steroids, and those who rely on NSAIDs every day for chronic pain. Drinking alcohol regularly adds to the risk as well.
Warning signs to take seriously
Stop the medication and seek medical advice if you notice stomach pain that does not go away, black or tarry stools, vomit that contains blood or looks like coffee grounds, or indigestion that keeps returning. These can be signs of bleeding or an ulcer, and they should be evaluated promptly. Even milder symptoms are worth mentioning to your care team if they persist.
Using pain relievers safely
A few habits lower the risk considerably. Take NSAIDs with food, use the lowest dose that relieves your symptoms, and take them for the shortest time you need. Check labels before combining products, because some cold and flu remedies also contain an NSAID.
If you find yourself relying on these medications most days, talk with your care team about other ways to manage pain; for some patients, a doctor may also recommend a medication that protects the stomach. And if stomach symptoms do develop, a gastroenterologist can evaluate them and help you find an approach that eases pain while protecting your digestive health.