Mixing Aspirin, Other Painkillers Boosts GI Risks

WASHINGTON -- Research has shown that medications such as ibuprofen and naproxen, known as non-steroidal anti-inflammatory drugs, or NSAIDs, can increase a person's risk for gastrointestinal problems, but a new report shows that when you add aspirin to the mix, the risk goes up significantly.

The news comes at a time when more people are turning to over-the-counter pain relievers. Millions of people take an aspirin a day to protect their heart, and plenty more take ibuprofen and naproxen for arthritis and daily aches and pains, reported WRC-TV in Washington, D.C.

A new study, which included more than 50,000 people medical records, revealed how certain combinations raise the risk for those gastrointestinal problems.

Researchers from the University of Utah and Pfizer Inc. found that people taking both naproxen and aspirin were 2.5 to 2.74 times as likely to develop GI problems such as ulcers, perforations or bleeding compared to people just taking naproxen.

Those who added aspirin to the mix had a higher risk. People taking a combination of ibuprofen and aspirin were 3.4 times as likely to develop GI problems compared to people just taking ibuprofen. For the naproxen and aspirin users, their risk was 2 times higher than those on naproxen alone.

The findings were presented Monday at a meeting of the American College of Gastroenterology.

"An aspirin alone can put you at serious risk, but if you add anything to it -- the naproxins, the Aleves, the Motrins, the ibuprofens -- these more than double your risk, they almost triple your risk, for serious bleeding, ulcers, erosions, side effects from those medicines," said Dr. Martin Bashir, a gastroenterologist at Washington Hospital Center.

Bashir wasn't surprised by the findings, but he said they serve as an important reminder and come at a time when they're seeing more people with GI problems.

"We are seeing a lot more of it coming into the ER because people are forgetting," he said. "The awareness of it is gone."

Bashir believes the awareness about the potential dangers of some pain relievers wore off when people turned to the arthritis drugs Vioxx and Bextra. But now that those are off the market, more people are going back to the over-the-counter pain relievers.

Bashir advises limiting use of those medications and talking to a doctor before combining those pain relievers with another medication. He said people should always tell their doctors what medication they are taking, including all over-the-counter medications.

"The Prilosec, Prevacid, Nexium -- those drugs have been shown to reduce dramatically the risks of having GI damage," Bashir said.

The GI problems can usually be corrected, but as people get older, the damage can be more serious.

In a separate study released Tuesday, researchers at McMaster University Health Science Centre in Ontario found that people who take high doses of ibuprofen on a regular basis are three times more likely to experience GI bleeding than those who do not take painkillers.

The results of the small study are published in the journal Clinical Gastroenterology and Hepatology.

"Of all the NSAIDs available over-the-counter, ibuprofen was thought to have the least harmful effects on the GI tract," said Dr. Richard Hunt, the study's lead researcher. "However, our study shows that healthy, young people and older people are at great risk of internal bleeding and should speak with their doctor to determine the risks of taking large amounts of ibuprofen."