Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group NSAIDs or not?

I quite happily took NSAIDs daily at maximum doses as long as I sensibly could, because that was the only antiinflammatory option available to me, and it was one that worked (in that it gave me really good relief and allowed me to function fairly well). I was well aware of how they could affect my stomach, and made the decision that I wasn't going to put up with any stomach upset at all, and the moment that happened I would first change the NSAID and then stop them. The first one I managed to stay on for about 4 years, then after that tried several more, but in the end had to give up. So, I guess from my experience, the answer is - yes, take them, but don't persist with them if you start getting negative effects.

You would think there would be some research on which nsaid is safest for the gi tract. I know someone suggested it might be Relafen, but I can't remember where I read that and what the rationale was.

Jakc, I think you've thought it through the same way I would have regarding biologics.

Honestly, the diet didn't do anything for me. I won't begrudge others their opinion, but I'm just not seeing it as a major treatment because so few have a good response to it (compared to other treatments like NSAIDs, biologics, MTX). But I've not studied it in depth. Since it's a diet and there is no real way to quantify it in a double-blinded study, the answer of whether it works as well or better than mainstream treatments will likely not be found.

My experience was: if the NSAID was effective on the inflammation and pain, then it gave me side effects (usually gastritis and edema). The more effective, the worse the side effects. And those that didn't give me much side effects also weren't very effective.

That kind of made sense to me and my doctor. Either they affected me, in both good and bad ways, or they didn't.

I'd be honest, but too, if one tries a bunch, and stops each one as soon as one either has negative side effects or realizes one doesn't work, and does that for up to the 8 months total. Or better yet, if you can't find one that works without side effects, then find one that doesn't work but also doesn't have side effects and just take that one or two for the 4 months each to get to the biologics.

By the time I was offered a biologic, I had been through 11 nsaids and cox 2 inhibitors (8 nsaids, 3 cox2 inhibitors. I wasn't on any of them for very long, but it added up. I tried all but one class of them. The ones that did nothing, good nor bad, those I tried for a month each, but it was kinda pointless except to get me to the other side...the side that would allow me to get on a biologic.

Play the NSAID game if it will get you to the biologics to try, just do so carefully. First hint of negative side effects and I was like "next please!" Don't play around with them if you notice anything negative. And some people can tolerate them on a daily basis; I couldn't. Not any of the 11.

All NSAID are poison and can make you more ill.

Hi
I was prescribed NSAIDS from the age of 19 to about 37 - in the beginning I'd be taking them for about 40% of the time but by the age of 26 it was max dose every single day.

I didn't experience any side effects that I knew of at the time, I was constantly constipated (but my diet was terrible) and used to drink quite a bit in my 20s.

Around 33 ish a rheumatologist noticed I wasn't prescribed any stomach protectors and subsequently I started on those. It was probably too late in the day as at 37 I experienced gastritis - badly - I felt awful. After a few tests, more drugs (PPIs) and a endoscopy the conclusion was - gastritis and a bleed. So no more NSAIDs for me.

Looking back I probably had mild gastritis for some time - but you probably understand how when you are in a lot of pain from the AS, you can ignore other pain.

I don't regret taking the NSAIDs as without them I would not have been able to go to work or look after myself. And I don't think the biological drugs were around then.

No idea what the inside of my stomach looks like now. Damaged I suspect.

I cannot take a single pill of NSAID without feeling stomach pain all night. Even if I take it with something as powerful as omeprazole, I can't survive NSAIDs for more than a week without severe stomach pain. It wasn't always like this. Back in 1995 I had some medical problems that required me to take a heavy dose of NSAIDs for three consecutive months. I tolerated NSAID for most part of that treatment(without antacids) until I got an ulcer two months into the treatment. And it has never been the same. I guess NSAIDs so badly affected my gut at that time that since then I have never tolerated them.

NSAIDs are usually my first line of defense (I'm in between prescriptions for AS, right now) when I wake up in pain. Most days, I'll keep about 600mg of ibuprofen in my pocket and try to hold out as long as I can throughout the day. On particularly painful days, I take it right away.

I'd say I end up taking the 600mg maybe three or four times a week, on average.

So far, I haven't had any gut problems - and I've been doing this for a few years. However, I also happen to stick pretty closely to the NSD, which I believe has helped my gut lining stave off any potential damage from the NSAIDs.