Does Ibuprofen Cause Constipation?
Almost everyone occasionally seeks pain relief from over the counter pain medication. Often, we reach for non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for pain relief of common ailments like toothache, arthritis, headache, acute injury, and gout. Ibuprofen is affordable, can easily be purchased in many stores, and is commonly recognized under brand names like Motrin or Advil, but it can sometimes cause unpleasant side effects.
While many people believe that over the counter pain relievers like ibuprofen are automatically safe and risk-free because they are sold without a prescription, they can cause issues when taken in large quantities. The problem is more common than you might think--recent studies have found that about 15 percent of adults take greater quantities of ibuprofen and other anti-inflammatory drugs than is recommended for daily use. While many people are aware of the possible side effects of NSAIDs such as the increased risk of gastrointestinal bleeding and ulcer, it's less known that ibuprofen can be one of the causes of constipation. If you find yourself wondering “does ibuprofen cause constipation?” you’re not alone.
Ibuprofen belongs to a class of medications called nonsteroidal anti-inflammatory drugs, or NSAIDs. This type of medication works by reducing the production of prostaglandins, which are naturally occurring substances in the body which can causing pain, inflammation, and fever.
Although those effects are unpleasant, prostaglandins are also helpful, as they help the kidneys function normally, protect the stomach lining and intestines from stomach acid, and aid in blood clotting by activating blood platelets. Prostaglandins are produced by the enzymes COX-1 and COX-2. Although prostaglandins produced by both enzymes produce inflammation, pain, and fever, COX-1 is also capable of producing the beneficial prostaglandins that promote blood clotting and protect the stomach and intestinal lining.
Some NSAIDs, like ibuprofen, are said to be non-selective, meaning they block the effects of both COX-1 and COX-2 enzymes, while selective NSAIDs block only the action of COX-2 enzymes. Medications that block both enzymes are associated with a higher risk of gastrointestinal side effects like bloating and stomach pain.
Ibuprofen is a fast-acting pain reliever that lasts in the bloodstream for about four to six hours. Therefore, it is best suited for pain relief and fever that is suffered acutely, like pain or fever associated with a sports injury, menstrual cramps, or the onset of an illness.
Ibuprofen can be taken to manage mild to moderate pain and inflammation, but it is not well-suited for managing chronic conditions like rheumatoid arthritis because of how often it must be taken, so it's not likely your health care provider will recommend ibuprofen for long-lasting issues, a prescription drug likely being the answer instead. This is because using ibuprofen regularly for extended periods of time can cause an increased likelihood of side effects and an increased risk for kidney disease.
Side effects associated with ibuprofen are generally mild, but can sometimes be serious. Gastrointestinal bleeding and stomach ulcers, kidney disease, and increased risk of heart attack or stroke in patients with cardiovascular disease are possible, especially in patients with risk factors for these side effects, such as high blood pressure.
However, ibuprofen is generally considered a safe medication, which is why it is sold over the counter and made easily accessible as a non-prescription drug.
Common side effects associated with ibuprofen include:
Abnormal renal function
Ibuprofen can be taken together with an antacid to help mitigate some of the possible effects like stomach pain, abnormal bowel movements, and overall digestive tract discomfort.
As noted in the list above, constipation is listed as one of the side effects of ibuprofen. Constipation is not one of the more well known side effects of ibuprofen, but it can occur, especially among the elderly. It should be noted that compared to prescription pain relievers like hydrocodone, oxycodone, or codeine, ibuprofen has a much lower likelihood of causing constipation. If you experience any of the following warning signs of constipation, seek medical the medical advice of a healthcare professional:
Blood in the stool
No bowel movement for four or more days
Loss of appetite
Vomiting or abdominal cramps lasting more than two hours
Unexpected weight loss
If taking ibuprofen is causing constipation, there are a few things you can do to help treat your constipation, get things moving again, and prevent a future recurrence of the side effect.
Depending on the severity of your constipation, you can try any of the following to relieve your symptoms:
Add more fiber to your diet by increasing your intake of foods like fruits, vegetables, whole grains, and beans; prunes in particular are a great support to the digestive system
Increase your fluid intake
Make sure to get some moderate exercise in each day if possible, like taking a brisk walk around the neighborhood
Consider adding an over the counter stool softener such as Docusate, a laxative like Miralax, or a stimulant laxative like Dulcolax
Risks and Warnings
In addition to the common side effects listed above, NSAIDs like ibuprofen have the potential to cause damage to the stomach, kidneys, and heart when taken for extended periods of time at a high dose. An increased risk of developing ulcers and gastrointestinal bleeding is most commonly associated with ibuprofen; as a non-selective NSAID, ibuprofen blocks the action of COX-1 and COX-2. Because COX-1, which produces prostaglandins that help protect the lining of the stomach, is blocked, the stomach receives less protection than it normally would. Therefore, gastrointestinal bleeding and ulcers are more likely to occur, especially in patients with a history of these issues. As a result, NSAIDs should only be taken for the shortest amount of time possible to provide relief for your symptoms, and you should always take the lowest dose that alleviates your symptoms. Even when taking a higher dose, never exceed the maximum doses listed on the label.
Patients with irritable bowel syndrome are generally advised to seek other NSAIDs with fewer implications on bowel movement distress or the digestive tract in general, with acetaminophen (Tylenol) a common go-to for IBS pain relief without added constipation. Consult with your gastroenterologist if you find you're having trouble finding appropriate substitutes.
When ibuprofen must be taken for longer than a few days, it should be paired with a proton-pump inhibitor like omeprazole or esomeprazole to provide some protection for the stomach. The good news is that ibuprofen has been shown to have a lower risk of gastrointestinal bleeding and ulcer than other NSAIDs, including Aleve.
Patients who are over the age of 65 and have pre-existing kidney disease are more likely to experience acute kidney injury when taking ibuprofen. All NSAIDs carry similar rates of kidney damage.
Ibuprofen and all other NSAIDs carry a risk of causing a heart attack or stroke when taken for an extended time at a high dose. Therefore, patients with heart disease or heart failure should use caution and speak to their doctor before taking NSAIDS for long periods of time.
Even though ibuprofen and other NSAIDs are an over the counter non-prescription drug, it's still always wise to obtain as much health information as you can, and don't be afraid to consult with your healthcare provider if you have concerns about the effect nonsteroidal anti-inflammatory drugs may have on your existing medication regimen.