Combat the Drawbacks of Nsaid With Aloeride

When you injure yourself and get a painful inflammatory reaction in muscles, tendons or joints, you are likely to be prescribed Non-Steroid Anti-Inflammatory Drugs (NSAID) or you may get some over-the-counter yourself. Per year some 25 million NSAID are prescribed in the UK, some 70 million in the USA and some 10 million in Canada.

NSAID are overwhelmingly successful in helping acute and chronic pain. However their use has significant drawbacks: adverse effect on kidneys, asthma gets worse in some people and most importantly NSAID as well as Aspirin cause stomach and duodenal erosions. These can become ulcers, some of which bleed and in some folk who have bleeding ulcers, the bleeding is sufficiently severe to result in hospital admission and may cause death. A US study puts the human impact of NSAID-related gastrointestinal deaths into perspective: the rate is higher than that found from cervical cancer, asthma or malignant melanoma. [G Singh. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. American Journal of Medicine 1998 105(1B): 31S-38S.] Quite an eye opener by any standards.

Good doctors prescribing NSAID try to balance their benefits and harms. So you may get so called gastroprotective medication (e.g. Misoprostol, PPIs and H2RAs) to try and offset the commonest side effect of NSAID. Proton pump inhibitors (PPIs) and H2 Receptor Antagonists (H2RAs) cause acid-suppression. This means there is less acid to irritate the erosion or ulcer. However, this co-medication does not give your body any tools to heal that iatrogenic NSAID-related lesion. It merely forces a lesser irritant during ongoing erosive onslaught.

Rather than just lowering acidity, which you actually need for a proper digestion of foods, it would be an extremely sensible approach to take a mucosoprotective agent that accelerates the healing of existing gastroduodenal ulcers and may prevent them in the first place. That specific agent is Aloeride® aloe vera capsules at a minimum of 2 capsules a day. There is plenty of good research to support this approach. [Blitz, J.J.; Smith, J.W.; Gerard, J.R. Aloe Vera Gel in peptic ulcer therapy; Preliminary report. Journal of the American Osteopathic Association. 1963.62.731-735.; Galalee, Kandila, Hegazy E, El Ghoroury M, Gobran W: Aloe Vera and gastrointestinal ulceration, J Drug Res Egypt 7:73-77, 1975.; Gupta MB, Nath R, Gupta GP, Bhargava KP: Antiulcer activity of some plant triterpenoids, Indian J Med Res 73:649-652, 1981.; Kandil A, Gobran W: Protection of gastric mucosa by Aloe Vera, J Drug Res Egypt 11:191-196, 1979.; Koo, M.W.L. Aloe Vera; anti-ulcer and anti-diabetic effects. Phytother Res. 1994. 8(8). 461-464.]

In the UK those 25 million prescriptions resulted in 12,000 NSAID-related hospital admissions which resulted in 2,600 deaths. Those 70 million USA prescriptions resulted in 100,000 NSAID-related hospital admissions which result in 16,500 deaths. Now bear in mind that these figures occurred despite doctors being mindful of the harms and co-prescribing gastroprotective medication in line with present medical guidelines. These numbers represent people who thought they would be alright taking NSAID. And these are only the ones that needed hospitalisation, the number of people who actually had symptoms of erosion/ulcers but weren’t seen beyond Primary Care is of course much higher. [statistical data from Bandolier Journal]

Alternatives to NSAID come in the form of enteric coated proteolytic enzymes and some of these have a lot of good research behind them. All well and good but for sledgehammer effect NSAID remain unbeaten. So the occurrence of NSAID-related stomach and intestinal erosion/ulceration is unlikely to change and in the famous words of Clint Eastwood (Dirty Harry) you can be asked “Do you feel lucky?” Because for 12,000 people in the UK and 100,000 people in the US it didn’t pan out that well and the families of 2,600 Brits and 16,500 Americans now put one less plate on the dining room table every evening. Excellent analgesics and anti-inflammatories NSAID may be, but there is a price to pay.

Present Medical Directive guidelines cause significant cost in human terms as well as in financial terms. In addition to the cost of NSAID themselves, the cost to the National Health Service for NSAID-related gastrointestinal adverse effects is some £331 million in co-prescribing and some £36 million in hospital costs.