We saw in class some of the dangers of nonsteroidal
anti-inflammatory drugs (NSAIDs) particularly when it comes to the GI tract and
stomach lining. Alcohol can also cause complications to the upper GI tract and
stomach lining. The aim of this blog is to understand the interaction between
NSAIDs and alcohol and the effect it has on acute upper gastrointestinal
bleeding (UGIB).
One study decided to take these two independent risk factors
of UGIB (NSAIDs and alcohol) and explore the combined effect. They took 1,224
patients who were admitted to a hospital for UGIB and gave them lifestyle questionnaire
surveys. They compared these patients with 2,945 neighbor controls. The survey included questions about medical history,
medications used, as well as alcohol consumption. Alcohol consumption was
further broken down to frequency of use, quantities used and date of last
consumption. They found that as alcohol consumption increased the relative risk
of acute UGIB also increased. Introducing Aspirin (including low doses) raised
the relative risk at all levels of alcohol consumption. The largest raise in
relative risk came from those who took aspirin regularly (greater than 325mg a
day) and also consumed alcohol. Regular use of Ibuprofen also increased the
relative risk of acute UGIB in drinkers but there was no significant increase
in risk when Ibuprofen was used occasionally. They conclude that while alcohol
consumption and NSAIDs independently increase the risk of UGIB, the highest
incidence is seen in patients who are both heavy drinkers and regular users of
aspirin and/ or ibuprofen.
I think the purpose of that study was to show how these
readily available, seemingly harmless drugs need to be taken seriously. While I
don’t think it was within the scope of this paper to address the hangover
curing ibuprofen once in a while, I think the implications of taking an aspirin
regiment for cardioprotection or other preventive measures are something that
could be addressed by health care professionals. Taking an aspirin regiment
could mean considering lifestyle changes, especially when it comes to alcohol
consumption. It should also be encouraged to visit a professional who obtains background
information before taking regular doses of over-the-counter NSAIDs.
Sources:
Kaufman DW, et al. “The risk of acute major upper
gastrointestinal bleeding among users of aspirin and ibuprofen at various
levels of alcohol consumption.” Am J
Gastroenterol. November 1999;94:3189–96.
Miller, Karl E. “Alcohol and NSAIDs Increase Risk for Upper
GI Bleeding.” Am Fam Physician. 2000
May 1;61(9):2863-2864.
Great post! We highlighted the use of alcohol and aspirin/ ibuprofen in class and I like that fact that it was a topic that the class was really engaged in so you continued to give more information. I understand the connection and I am glad it runs parallel to the New York Times article we read in class; however did the study you found highlight any of the mechanisms and/or pathways that are used that cause UGIB with alcohol users. I am just curious to see how physiologically that happens. Also, a lot of times people aren't aware that the next morning after drinking when they are taking a ibuprofen that they usually still have alcohol in their system when they may not realize it so I'm glad you mentioned the "hangover cure" as well. Very informative!
ReplyDeleteThanks Anaiz! Unfortunately the study did not propose a mechanism, but if I took a quick shot at it I would say that alcohol may increase the acidity in the stomach when it is already weak to acid due to inhibition of COX-1 from the NSAID
DeleteInteresting post. The conclusions of the study seemed to make a lot of sense, as problems arise when we take NSAIDs chronically. Moderation seems to be key when it comes to NSAIDs. I agree that the while the common view about aspirin being cardioprotective may be true, it needs to undergo a change so that the risks are just as well known.
ReplyDeleteNice post, it aligns very well with last weeks topics of discussion in class. As we know, NSAIDs work by inhibiting the Cox-1 and Cox-2 enzymes so it does make sense that GI bleeding can occur. I did some more research and found that excessive alcohol consumption can cause alcoholic gastritis, a condition characterized by irritation and bleeding of the stomach lining.The excessive alcohol consumption irritates the stomach lining and can even cause ulcers.
ReplyDeleteHey Jameson, I was under the impression that aspirin caused scarring in the liver tissue and ibuprofen caused gi bleeding when combines with heavy alcohol use. Please correct me if I'm wrong, but that was my understanding from last week's papers. Anyway, I'm certainly glad I learned about this in class, I'll stick to the old re-hydration and sleep hangover cure, but it'll be good to warn my family and friends about the dangers of NSAIDs.
ReplyDeleteHi Mario, I agree it will make me think twice before reaching for my ibuprofen! Both NSAIDs have been shown to be capable of causing GI bleeding. I think the analgesic acetaminophen is more commonly associated with liver damage.
DeleteI thought it was a good point to bring up that if one is going to be put on an Aspirin regimen than life-style changes should be considered. Alcohol increases ones chances of developing many diseases and also should be consumed responsibly. It is also important to realize that while it may not be a good idea to take Ibuprofen for a hangover, that it is not an every day occurrence. Lastly, regarding the study you mentioned, I wonder how accurate the survey really is, I feel that people tend to lie, or downplay the negatives in life - such as smoking or alcohol consumption.
ReplyDeleteThanks for the post! I like that you brought up "lifestyle changes" because I think that's ultimately the biggest thing people today can do. Of course, people are going to do what they want to do, but I think informing them that a small lifestyle change, by not taking these medications after alcohol consumption, can really make a big difference in the long run. I think it would be interesting to see also how much of a risk increase there is for a person if they only take these medications as a "hangover cure".
ReplyDeleteThis was a very good study to reference. It makes sense that it would be okay to occasionally take medications like Aspirin for, example, a hangover. Like it was mentioned in class it would seem that most of this information would be common sense, but most people don't have a physiology background like our class does. It's good to know that there are studies out there that have shown it's okay to occasionally take NSAIDs even with alcohol in the system.
ReplyDeleteYour post made me think about why NSAIDs and/or alcohol would be associated with GI bleeding particularly since the study only showed a correlation. I think that inhibiting the functioning of platelets through the use of NSAIDs will increase the risk of bleeding in general as platelets are integral for clotting, so relatively minor irritation to the GI tissues may result in bleeding. Taking the NSAIDs themselves could cause irritation leading to bleeding, or as Michael said above alcohol or something else could easily be a source of irritation.
ReplyDeleteInteresting post, Jameson! I read somewhere a while ago that if you are going to take a pain killer for a hangover, the worst one you can take is acetaminophen, because it is the most toxic to the liver. The supposed better alternatives were naproxen or ibuprofen. I wonder if in your research on the topic, you ever came across similar information? I thought it was an interesting (and useful) fact if its true!
ReplyDeleteThis was a very interesting study that probably pertained to a lot of us. I think that all too ofter people misuse or abuse the use of aspirin or any NSAID for any ailment that comes their way. This really brings to light the reality of overusing painkillers and that there are risks involved. I agree too that while this didn't involve hangover in the study, that was definitely the first thing I thought of. It would be interesting to see the results of alcohol consumption with other NSAIDs to see if they proved to have similar risks.
ReplyDeleteI really liked how you talked about the implications of the information in your post for medicine and society. I think we will see more and more a move towards patients playing a larger role in their medical decisions. The availability of information online will lead to more interested and educated patients. Doctors should still be responsible for informing their patients but I foresee a give-and-take situation where a patient googles their low dose aspirin regimen, talks to their doctor about some recent research they discovered, then the doctor takes what they learned and applies it to other patients. If something like this does come to fruition I think it could lead to significant improvements in treatments and patient involvement.
ReplyDeleteHi! I liked your article and how it talked about the health risks in regards to alcohol, nsaids, and UGIB. It makes sense cause I mean.. we all know that adding alcohol and medicine together does nothing but damage to our health (and it could even be fatal). From what I know (and correct me if I'm wrong), when you're hungover, you still have some alcohol left in your body and taking medicine as soon as you wake up would be a bad idea. So I think it would be kind of cool if a chart or something could be developed and if it could tell you (based on how much alcohol and water you drank the night before) how long you would need to wait before taking medicine. I hope my comment made sense. I couldn't think of any better way to articulate it, aha.
ReplyDeleteGood post! I agree with you that aspirin and other NSAIDs need to be taken more seriously, especially along with alcohol use. This post definitely relates to us more closely than most of the other articles that we've read being that we're in college and many of us take Advil after a night of drinking to relieve the headache. I do think that this should be paid more attention to, however it is also very difficult to make people read warnings and labels in today's world no matter how blatantly obvious they are. I think that the easy access to NSAIDs as over the counter drugs contribute to this. Maybe having people buy drugs like these be required to buy it from a pharmacist who directly warns them of the risks and not to use with alcohol would be most beneficial. However this also introduced a great amount of inconvenience for users who understand these risks and are using the products correctly.
ReplyDelete