Ulcers: Everyday Pain Relief (cont.)

How Do Pain Relief Drugs Work?

In a certain way, all pain is in your head. When we feel pain, it's the result of an electrical signal being sent from the nerves in a part of your body to your brain.

But the whole process isn't electrical. When tissue is injured (by a sprained ankle, for instance), the cells release certain chemicals in response. These chemicals cause inflammation and amplify the electrical signal coming from the nerves. As a result, they increase the pain you feel.

Painkillers work by blocking the effects of these pain chemicals. The problem is that you can't focus most pain relievers specifically on your headache or bad back. Instead, it travels through your whole body. This can cause some unexpected side effects.

What Are the Risks for People With Ulcers?

Why do painkillers increase the risk of gastrointestinal (GI) problems? The same chemicals that amplify pain -- which some pain medicines block -- also help maintain the protective lining of the stomach and intestines. When a painkiller stops these chemicals from working, the digestive tract becomes more vulnerable to damage from gastric acids.

For people with ulcers, the risky pain relievers are nonsteroidal anti-inflammatory drugs, or NSAIDs. They include aspirin, ibuprofen, naproxen sodium, and ketoprofen, the active ingredients in medicines such as Bufferin, Advil, and Aleve.

Other pain relievers may be less dangerous. Acetaminophen -- the active ingredient in Tylenol -- works differently and poses a much lower risk of GI problems. However, like any drug, it does have side effects of its own. You shouldn't take any over-the-counter painkiller for more than 10 days without your health care provider's approval.

The risks from NSAIDs are quite serious. Studies show that people who use NSAIDs are about three times as likely to have gastrointestinal bleeding. Even at low doses, NSAIDs can make mild ulcers much worse.

Aspirin has additional risks. "Aspirin can help prevent blood clotting, which is why it helps people at risk of heart attacks and strokes," says Cryer. "But in people with ulcers, it can lead to more serious gastrointestinal bleeding."

However, what if you have an ulcer and a high risk of heart attack or stroke? Then what do you do? Cryer admits that balancing the benefits and risks of these medicines can be tricky.

"People need to talk to their doctors to figure out what's best in their case," he says. But in people with a high risk of heart attack or stroke, he says that the cardiovascular benefits of aspirin can outweigh its gastrointestinal risks.