Category: Science

NSAIDS, The Gut, and Inflammation

As I have discussed on many occasions in this forum, the process of inflammation is a cornerstone of virtually any degenerative condition in the human experience. This includes diseases like cancer, diabetes, coronary artery disease, Alzheimer’s disease, Parkinson’s disease, stroke, arthritis, and so many more. So it’s really important that we take a step back and try to gain an understanding as to what influences inflammation in the first place.

I am certain that many of you now embrace the notion that a “leaky gut” predisposes us to this process of inflammation. Basically, in the healthy condition, the gut lining is selectively permeable, as well as selectively impermeable, to various bacterial components, proteins, and other gut related particles. When the integrity of gut lining is challenged, these entities gain access through the gut wall and stimulate immune reactions that activate the production of inflammatory chemicals.

So it’s really very important to gain an understanding as to the factors that can lead to loss of integrity of the gut lining and, as such, a “leaky bowel”.

Commonly recognized causes of loss of bowel integrity include exposure to toxins, antibiotic exposure, pathogenic bacteria, and even emotional stress. In addition, it is now recognized that certain medications may lead to increased bowel permeability as well. There has been a lot of attention given to the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in terms of damaging the gut lining and leading to inflammation, the very problem for which these drugs have been designed to help!

New research demonstrates in the laboratory animal that exposure to NSAIDs not only compromises the barrier function of the lining, but in addition, and probably because of the effects upon the gut lining, this class of medications, at least in the laboratory animal, induce gluten sensitivity.

This is fairly breathtaking information. With the rapid expansion of gluten sensitivity in Western cultures, and people scratching their heads wondering why this is happening, we now have at least a conceptual explanation represented by one of the most commonly used class of medications in our society, the nonsteroid anti-inflammatory drugs.

Again the emphasis is on maintaining gut wall integrity. This is the key to reducing inflammation, which, as mentioned, place such a pivotal role in so many diseases that are common in Western cultures.

  • Lynn Dell

    Three/four years ago, my husband decided to go get regular check ups, and went to an MD his brother recommended, not the doctor he had been seeing . . . some time elapsed . . . my husband started to develop patchy, itchy rashes, primarily on his back and abdomen. He went back to his original doctor not the first one, who injected him with steroids, and my husband felt lots better, and then. . . some more time elapsed . . . and the itchy rashes broke out again. . . so my husband saw the MD his brother recommended to him, who referred him to a dermatologist. The dermatologist said my husband had urticaria.

    WOW! a new word!

    I looked it up. It means, “hives.” Cool! So now we knew he had hives, but etiology unknown. But he did walk away with a tub of cortisone cream, which helped a little, but not much.

    We can’t remember the exact order of things, but during this time it so bad he went to urgent care, where the MD there said it looked as though he had (I think) scabies. So he went on a treatment for that.

    Meanwhile, I was upset and my husband was distracted. We are talking months and months of very distracting, patchy itching of reddened skin. So I asked my husband what he started doing differently around the time of seeing the first doctor. No prescription medications, just a baby aspirin per day.

    So, I decided to google “aspirin hives” and it finished the search for me. I looked on my husband’s aspirin bottle, and sure enough, there was the warning about hives.

    I may have called my husband, the first doctor, the second doctor, the dermatologist, and the emergency room doctor some uncomplimentary name all at once, and I ordered my husband off the baby aspirin, although I had no license to do so. It took several weeks, but the hives went away.

    I know nothing of an aspirin gluten connection. But I know there is an aspirin stress level connection for me!

    And this was the first serious wake up call to me that conventional medicine is so focused on treating symptoms and not taking time to think through matters to get to main causes, and that I had to take charge of health, for me, and my family. And this led me on a journey to take care of stuff I was doing very wrong . . . which led me to Dr. Perlmutter, Dr. Davis, Dr. Lustig, Dr. Hyman, Dr. Mercola, and others who are bringing a needed correction to the myopic craziness we were put through a couple years ago.

    I guess I have aspirin to thank for all this, but just remembering it gives me a headache, and there is nothing to take for it! 😉

    • Kelley P

      That is my exact group of “go to” doctors for health information too!

    • CED

      how about a cup of turmeric tea for your headache.

      • Lynn Dell

        Great idea!

  • Bet Sobon

    Nasids destroyed my intestines. My own fault I guess. It’s take 2 years, but I think I’m finally getting healed. And yes, it can cause gluten intolerance. And gluten intolerance is real.

  • Bonnie Witchley

    i’m thankful for all your advice…i really haven’t gone to a dr since 1985 86 except for cataract surgery and physical 2012…lab test good…that said i have eliminated most food substances 90% that are bad…last six months….no processed food except some organic and absolutely wheat free …still have a little problem with knee (injury) and neck but am working on natural remedy to build collagen for 2 weeks now and it is working…i haven’t had medical insurance since 1986 and still don’t qualify with new health care here in Florida….they didn’t except it here…low income

  • martin

    Hi Dr. Perlm. Could you describe your recommendations for healing a “leaky gut”, either in this thred or in a new post?

  • allessio77

    So what do you do for arthritic hip pain if NSAIDS are out?

    • Bill B

      The best treatment for my arthritic hip pain is strict adherence to the Grain Brain diet. After 4 months, how is yours?

      • allessio77

        I eat minimal to no grains, and still have nightly hip pain. My doc prescribed the NSAIDS.

        • Try curcumin and you can take a LOT unless you have an active ulcer +decaf green tea+ fish oils

        • David Mc D

          I think with hip pain , you have worn the joint down and will have to deal with it . Tumeric and diet cannot repair the damage

  • Lori Howe

    I have to take antibiotics before every dental appointment due to joint replacements. Which is worse, antibiotic exposure or infection?

    • KGud

      Check with your surgeon and dentist. It may be only for 2 years.

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  • KGud

    I don’t think there is Indomethacin in Motrin or Advil or Aleve. How do you make the leap that these NSAIDs would have the same affect?

  • HesterJane van der Straaten

    What animals are used? I’m not keen in gaining advancements in my health from torturing animals.

    • Leslie

      All advancement in meds need to use animals. You will not use anything if that is where you draw the line. Being in the loop, I can say it is a lot of mice that are used. Having 2 children have had cancer and lived I am so grateful for that research.

  • David Haddon

    And just over the counter and prescription medicines do NSAiDS include?

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  • Lynn

    How do I cope with arthritis pain without steroids or NAISDs?

  • Canuckiwi

    I suggest that it would be wise to consult with a talented chiropractor. Often what is presumed to be causing the pain, [even if arthritic changes are verified as being present,] is not the case. When skeletal structural distortion is corrected often miraculous results are experienced.

  • Cheryl

    Dr Perlmutter, could you recommend a doctor or nutritionist in the Louisville Ky area? Or in southeast Florida in the winter months.

  • Pamela Sistrom

    Hi, Dr P, I tried to reply to a post about recent scientific confirmation of Grain Brain approach to Alzheimer’s, but after re-setting my PW, it was gone. I am 74 y/o woman with maternal Hx dementia. GM a tea totaled, mother died of cirrhosis at 80. GM lived to her nineties, but had severe dementia from her seventies. Though not too obese, (165 and 5’6″) I have long had high cholesterol. I’m an RN, still working, but just can’t or won’t comply with statins! No heart disease, just Ca, ETOH and GB. My highest tot chol readings prior to trying GB diet were in high 200’s. After about six months eating lots of GF beef, eggs, pastured butter, and really trying with the no sugar, my tot chol now over 400! Once again, MD prescribed atorvastatin. It’s been two months. I’ve taken one! I take the DHA and ALA you recommend, but now I’m forcing myself to take 1Tbsp reg psyllium husk am n pm. I’m not great about exercise. I believe you’re right, but over 400 can’t be good. HDL is high but triglycerides and LDL even higher! My GM was said to have, “a series of small strokes which caused her dementia” according to her 1970’s Internist. So what should or an I do? I bought some red yeast rice but found out it’s really bad! I’ll try EPA. I’m cutting down on beef. I eat ground bison two, three times a week. Help! I have a 28 y/o daughter. I don’t want to be babbling like the nursing home residents I see at work!

  • Pamela Sistrom

    I will stop the Aleve. I’m already taking Bromelain and Quercitin PRN pain and Curcumin BID whether I need it or not! Aches and pains rt frozen left shoulder and hx LBP with laminectomy nineties. Fx humerus 2002.

  • Pamela Sistrom

    DT chronic constipation, I’ve also gone back to oatmeal and flax in AMs. Eggs two days.

  • David Haupt

    Question for Dr Perlmutter,
    Are you familiar with the probiotic product EpiCor? It was accidentally discovered in an animal food product factory here in Cedar Rapids, Iowa. It is a yeast they added to feed, and produced healthier stronger cattle. Workers that breathed the yeast daily were noticed to be rarely sick. It is promoted as an immune system stimulant.i have taken it for about three years and have not had a severe cold the last three winters.
    I am not sure what bacterium is in it.

    • John Jung

      I am interested in this, also. I have been taking it for about 3 years, too.

    • QuentonQuale

      The yeast you speak of is called Saccharomyces cerevisiae, a.k.a. “Brewer’s yeast”. Not a magical product. EpiCor just adds some Vit C and zinc to the blend. Not a bacterium–a fungus.

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  • Tim

    Hi Dr. Perlmutter, a neurologist recently did an ultrasound on my carotid artery. He said there was a little plaque in it, no blockage, but recommended I take a daily low dose 81 mg aspirin to get rid of the plaque so I don’t get a stroke years from now. I am a 63 y.o. male, w/ mother has vascular dementia, possibly some Alz also. I’ve been following the grain Brain diet fairly well for over 2 years. Should I take the daily aspirin, or is there an alternative you’d recommend to get rid of the plaque?

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  • Vicki Mizel

    if you have a gut infection how is the best way to bring down the inflammation?

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  • Margaret Ryan Martin

    Dr P, I just watched a video presentation on inflammation produced by United Naturals and Active Motion. It was in the context of NSAIDS and how bad for your gut they are. Do you have an opinion on Active Motion as an inflammation reducer. It seems to combine components that you often mention.

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