According to two studies published in the American Gastroenterological Association (AGA) journal Clinical Gastroenterology and Hepatology, prescription painkillers are effective in easing the pain of patients with dormant inflammatory bowel disease (IBD) and are not likely to cause symptom flare-ups in IBD patients in remissions.
Both studies examined the benefits of non-steroidal anti-inflammatory drugs (NSAIDs), including COX-2 inhibitors, in a patient population with ulcerative colitis and/or Crohn's disease. Study findings show that NSAIDs were well-tolerated, with COX-2 inhibitors offering the most effective pain relief in this group.
"In the past, physicians have considered ulcerative colitis and Crohn's disease as contraindications for prescribing NSAIDs. These studies represent an important advance for patients with inflammatory bowel disease and their gastroenterologists searching for safe medications to help with pain relief," said Joshua R. Korzenik, MD, author of an accompanying editorial from Massachusetts General Hospital in Boston. "Patients with ulcerative colitis and Crohn's disease can now use COX-2 inhibitors for brief periods of time to relieve pain with the assurance that they are not risking a flare-up of their disease symptoms."
Patients with IBD often need anti-inflammatory painkillers for peripheral arthritis, back pain, fractures and osteoarthritis. However, some researchers have argued that these painkillers have negative effects on IBD patients in remission. According to a study in this month's issue of Clinical Gastroenterology and Hepatology, patients with IBD who use NSAIDs tolerate the drugs well and less than one in three patients experiences a flare-up in symptoms. Furthermore, the study shows COX-2 inhibitors, previously thought to cause symptom recurrence in IBD patients, significantly reduce the likelihood of disease relapse.
To date, this is the most comprehensive study to address the effects of NSAIDs on disease activity in patients with IBD.
"Our findings suggest that patients with 'silent' inflammatory bowel disease requiring anti-inflammatory drugs tolerate NSAIDs very well, despite the minimal risk for disease relapse," said Ingvar Bjarnason, MD, study author. "If a patient with IBD requires an NSAID for pain relief then these drugs should not be withheld on the belief that they will cause worsening of disease symptoms."