I heard painkillers are harmful to my stomach

I heard painkillers are harmful to my stomach. Is that true?

Painkillers provide pain relief and reduce inflammation. The painkillers that we commonly find are paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Paracetamol is available over the counter while tNSAIDs are only available in pharmacies.

Have you ever heard of this question? Is it true that painkillers are harmful to our stomach?

NSAIDs: How does it work to relieve pain?

Prostaglandin is released when our body is infected or injured and the release of prostaglandin will cause inflammation, swelling and fever. Cyclooxygenase (COX) is an enzyme that is involved in the creation of prostaglandin. NSAIDs work by inhibiting the COX enzyme thereby helping in reducing pain and inflammation1. 

Types of NSAIDs: Non selective NSAIDs VS selective NSAIDs

Non-selective NSAIDs block both COX-1 and COX-2 while selective NSAIDs such as block COX-2 have little or no effect on COX-11.

How does the painkiller hurt our stomach?

Prostaglandin is stomach protective as it decreases the stomach acid secretion and protects stomach lining2.  Blocking COX-1 may impair gastric protection while blocking COX-2 provides anti-inflammation and analgesic action. Non-selective NSAIDs block COX-1 and COX-2 thereby leading to stomach upset.

Which doesn’t hurt my stomach?

All NSAIDs may cause serious gastrointestinal adverse effects. However, selective NSAIDs are generally associated with lower risk of gastrointestinal complications than non-selective NSAIDs3. People who have a history of gastrointestinal bleeding are advised to avoid all types of NSAIDs if possible or only use NSAIDs under medical health practitioner supervision.

Take home message

1. Take NSAIDs with food or immediately after meals 3. 

You should take it with food or after meals to reduce the side effects that are caused by NSAIDs. Avoid taking it with an empty stomach to prevent the risk of stomach problems. 

1. Talk to your doctor if you need a painkiller especially when you have gastric problems. Your doctor can advise on the type of painkillers with lesser gastric side effects 

This is an educational article from: