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NSAIDs & Ulcers

What's the Future?

At least 1 out of every 10 people will have a serious peptic ulcer episode in their lifetime.

That statistic concerns Lenard M. Lichtenberger, Ph.D., a professor and scientist in the UT Medical School at Houston's Department of Integrative Biology and Pharmacology, and ulcer researcher for more than 30 years.

His focus has been on how the stomach protects itself from gastric acids. He and his colleagues are pooling their years of knowledge to develop a drug, not for our stomachs, but for our aches, pains and arthritic conditions that won't pick a fight with our stomachs. He is working on the stomach-friendly NSAID.

NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, naproxen, diclofenac and ibuprofen as well as some new generation prescription drugs - can cause ulcers in many people if used over long periods.

NSAIDs are taken for many conditions ranging from headache to arthritis. In addition, the Centers for Disease Control and Prevention predict that, due to the aging baby boomers, the number of people with joint conditions is expected to rise sharply (57 percent) by 2020. That translates to a lot more possible NSAID-induced ulcers, not to mention other complications such as kidney compromise.

Lichtenberger says that just as many people take certain NSAIDs, like aspirin, to prevent cardiovascular events. And there is evidence that some NSAIDs are effective in Alzheimer's disease as well as reducing the risk of different cancers, such as ovarian and prostate.

"All of these are very strong medications. They have the same effect whether you take them on a full or empty stomach. Listen to your body," Lichtenberger advises.

"If you begin to feel weak or anemic, stop taking the medications and call your doctor to request a blood test to check for anemia (a result of a possible bleeding ulcer.) The GI tract can recover from most injuries very rapidly if the ulcer is not deep. A very shallow injury is called an erosion," he explains.

The GI tract has unique water-repellent properties. When any type of mechanical injury happens in the stomach, Lichtenberger says, it secretes an oily lipid mucus substance to coat itself. Both the Helicobacter pylori bacterium, the other cause of ulcers, and NSAIDs have the ability to remove that protective water-repellent coating after they form a chemical association with the molecules in the stomach.

Clinical studies reveal that people over 75 years of age, who have previously had an ulcer, have an increased risk of developing another ulcer with complications when taking a standard NSAID.

Understanding the caustic effect that these drugs have on the stomach, Lichtenberger and his colleagues began researching, then designing a medication that, like the Cox-2 inhibitors, would have anti-inflammatory and pain-relief properties but fewer risks and side effects.

The team worked to develop a new type of NSAID that would have a less toxic effect on the stomach. They reasoned that the compound would have to contain natural or synthetic elements that mimicked the self-protective properties of the GI tract. Lichtenberger's group has taken a natural approach and is working with soy phospholipids.

Currently, Lichtenberger's team is involved in drug trials with their new medication and a double-blind study involving arthritis patients is underway.

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UPDATED: 9-07-2004