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Title: NSAIDs & Exercise

Category: Orthopedics

Keywords: Exercise, NSAIDs, bowel injury (PubMed Search)

Posted: 12/22/2012 by Brian Corwell, MD

NSAIDs are commonly used by professional and recreational athletes to both reduce existing and/or prevent anticipated exercise induced musculoskeletal pain

NSAIDs have potential hazardous effects on the gastrointestinal (GI) mucosa  during strenuous physical exercise

Potential effects include mucosal ulceration, bleeding, perforation. and short-term loss of gut barrier function in otherwise healthy individuals

Intense exercise by itself has previously been shown to induce small intestine injury

Human intestinal fatty acid binding protein (1-FABP) is a protein found in mature small bowel enterocytes which diffuses into the circulation upon injury

Ibuprofen and endurance exercise (cycling) independently result in increased 1-FABP levels

When occurring together, ibuprofen ingestion with subsequent exercise causes significantly increased small bowel injury and intestinal permeability

Small bowel injury was found to  be reversible in 2 hours

Taking empiric NSAIDs before endurance exercise may be an unhealthy practice and should be discouraged in the absence of a clear medical indication

 

 

References

Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes. VAN Wijck K, Lenaerts K, VAN Bijnen AA, et al. Med Sci Sports Exerc. 2012 Dec;44(12):2257-62.


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