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A Bad Gut Feeling

Painkillers are popular. Nearly $2 billion are spent annually in the U.S. on prescription NSAIDs (nonsteroidal anti-inflammatory drugs), not to mention nonprescription drugs in this class (which include aspirin and ibuprofen).

These drugs, widely used for arthritis, take their toll: Every year, approximately 100,000 Americans are hospitalized and 16,500 die from NSAID-associated stomach-ulcer complications.

To reduce ulcer complications, specialized NSAIDs (called "COX-2-selective NSAIDs") such as Vioxx and Celebrex - which reportedly cause minimal stomach damage - are being prescribed for arthritis patients. To compare these "safer" treatments to other NSAIDs for arthritis, roughly 300 patients with arthritis and a predisposition to ulcer bleeding were divided to receive either regular NSAIDs or the special NSAIDs daily.

After six months, the probability of recurrent ulcer bleeding was nearly the same in both groups: about 6% in the regular-NSAID group and 5% in the special-NSAID group. Renal failure, hypertension and fluid build-up in the legs were observed in nearly the same number of patients in both groups, although the newer drugs appeared to offer some advantage.

The authors of this study in The New England Journal of Medicine note that patients receiving the new drugs showed an incidence of ulcer complications that continued to rise beyond the six-month study period. Arthritis patients at a high risk for recurrent ulcers don't appear to have a much safer treatment option in newer painkillers. Perhaps a holistic, drug-free approach to arthritis would be better. Talk to your chiropractor for more information.


Chan FKL, Hung LCT, et al. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. The New England Journal of Medicine 2002:347(26), pp. 2104-2110.

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