Some four years ago on this page, we discussed the properties of Ibuprofen as a pain relief medication. While a good number of readers have sought clarification about those uses from time to time in the question and answer section of this page, others have taken the liberty to use the medicine for just about any cause of painful discomfort often without a prescription. Definitely, it is safe to assume that even before that essay, many readers and people who have not read any article related to the uses of Ibuprofen have nonetheless consumed it with reckless abandon. In at least two instances, such reckless use of Ibuprofen led to massive intestinal bleeding in a two-year-old male toddler to the point that a major operation had to be undertaken to save his life. This happened after multiple blood transfusions were administered and the bleeding failed to stop. In a daring operation, the offending bleeding vessel was found inside the stomach and its prompt closure with a suture material brought all the tension to a dramatic end. However, a 45-year-old man who had been undergoing a fasting programme ordered by his church took this same medication for some nagging pain he experienced in his knee and an old stomach ulcer probably opened up and perforated. And although he was eventually operated upon, too much time had been wasted in going from one hospital to another and he eventually passed away.
Without a doubt, Ibuprofen is a widely used medication for pain relief and as an over-the-counter medication for a variety of conditions such as headache, menstrual cramps, fever, muscle pain, back pain, toothache and arthritis. It is called a non-steroidal anti-inflammatory drug (NSAID), and it works generally by reducing inflammation, which is a natural body response to injury or infection. Because of its widespread availability, it is important to understand the potential risks and side effects of the drug. Pain reduction is one of the most important ways by which this drug impacts our health. It accomplishes this by blocking the production of prostaglandins, which are chemical substances produced by the body when there is an injury or an infection that causes pain and swelling. It does this remarkable work by blocking and obstructing the enzymes which produce those prostaglandins, thereby bringing about a reduction in the severity of the pain and inflammation. In this role, Ibuprofen can be very effective, but it is not without risks. One of the most important risks of concern is its ability to cause stomach irritation, nausea, vomiting and stomach pain because it can cause irritation to the lining of the stomach. In some cases, this can lead to ulcers and bleeding in the stomach as we saw in the two individuals above.
This medication is available in several forms; it may be a tablet, caplet or syrup. In some controlled instances, especially in the operating room, an injectable form delivered as a drip is also available often deployed for pain control by anaesthesiologists. The tablets are available in several strengths such as 200mg, 400mg and 800mg. It can be taken once, twice or three times a day depending on the severity of the pain. Such pain may be mild, moderate or severe. The relief obtained is associated with reduced inflammation and swelling. It should be consumed with food or soon after a meal and never on an empty stomach. The drug may occur alone and at other times, it is presented in combination with other medications such as paracetamol. Here at home, that combination is found in Ibex, which is further potentiated by adding caffeine to it. The drug Ibuprofen may also be combined with prednisolone although this is likely to increase its gastrointestinal problems. It can similarly be combined with Tylenol. Although it acts similarly to paracetamol, for example, it bears a unique distinction of being metabolised and degraded in the kidneys. Paracetamol, by contrast, is metabolised in the liver. It is this association with the kidneys that Ibuprofen has that makes it able to cause kidney damage and even failure once its toxic level is reached or exceeded.
Another potential side effect of this medicine is that it can increase the risk of a heart attack in a person or stroke. This is because, as we discussed earlier, it can interfere with the production of prostaglandins which ordinarily have a protective effect on the heart and blood vessels. When prostaglandin production is reduced, the blood vessels become unusually narrow, which leads to the formation of blood clots, thereby increasing the likelihood of a heart attack or stroke. It is important to note, however, that these risks to the heart and blood vessels are much increased in those people who have a pre-existing heart disease or at high risk for developing that condition. These adverse effects often go unreported, and worse still is the fact that acute kidney failure and the aggravation of pre-existing heart failure are other serious health issues that are known to happen. Most of the time that our bodies experience pain, it is because there is ongoing work to heal from an injury or sickness. Therefore, the inflammatory response, which we also discussed on this page last year, is important for the resolution of health challenges that bring that specific response about. However, one major drawback of its use is that by blocking the inflammatory response it can actually make the process unduly long and therefore perpetuate pain.
In addition to the risks enumerated above, there is much evidence that Ibuprofen can also interact with other medications and supplements to the extent that it can decrease the effectiveness of some blood pressure medications, for example, such as the angiotensin-converting enzyme (ACE) inhibitors. This is a large group of medications used in the treatment of high blood pressure and heart failure. Through this same mechanism of inhibiting the effectiveness of prostaglandins, Ibuprofen can adversely affect or interact with the activity of blood thinners such as warfarin and increase the risk of bleeding. Despite these risks and side effects, Ibuprofen can generally be found to be a safe and effective treatment option for many people. It is, therefore, important to talk to your doctor or pharmacist before you take this medication. This is especially important if you do have any pre-existing health condition such as the ones we have named above or are taking any other supplements. In conclusion, Ibuprofen is a widely used NSAID that is effective in reducing pain and inflammation. It is noteworthy that in its class of medications can also be found others like aspirin, naproxen and diclofenac.
In the final analysis, it is the illiterate majority, plus those with a little amount of education, who have heard that Ibuprofen is good for pain relief that is most likely to misuse the medication; they will combine it with paracetamol and Indocid and perhaps add Tramadol to it and swallow all at once at any of the chemists and pharmacies that dot the landscape. Many of these consumers will not keep the medicine at home but will stop at the neighbourhood chemist every evening on their way from work to consume this abnormal concoction. Some have practised this kind of ritual for years.
Questions and answers
Dear doctor, it is a great job you are doing every Sunday. Please, do kindly get us a compendium of the column so far. I am a 66-year-old male with an Amlodipine 5mg-controlled hypertension that averages 130/80mmHg most times. Random blood sugar is 113mg per cent. My weight is around 62.3kg and I am 1.74 meters tall. Seven Julys ago, I woke up one morning to find my genitals covered with what looks like ringworm. The following day, I was at LASUTH (Lagos State University Teaching Hospital), Ikeja and the urinalysis requested came out thus: colour: deep amber; nitric acid: negative; urobilinogen: normal, specific gravity: 1.015; glucose: negative. Both overworked young doctors who attended to me could not agree whether the diagnosis should be due to bacteria or a viral infection. However, the agreement was that it was a very difficult organism to get rid of. I have seen other doctors without much success. Please I need to mention that my genital area is always covered with grime, suggesting that the infection is skin deep. Am I afflicted with an incurable disease? I believe that someone high up should have a solution. Who do I see? 080330****
Thank you very much for your kind words. Seven Julys ago is almost seven years. That is a very long time. However, it is a bit of a surprise that all this while, none of the doctors you saw referred you to a dermatologist. That is the expert on skin diseases who should be treating your condition. In all likelihood, this is possibly a fungal infection and is therefore, curable.
Dear doctor, greetings to you and family in Jesus name. Amen. I thank you for your early response to my enquiries on soursop and a flabby scrotum. However, I think that since soursop is produced from the same tree with roots and leaves, it could be logical to say that the leaves may have the same effects and properties as the fruit itself. About the flabby scrotum (hanging balls), has it no connection with the prostate, especially with regards to BPH (benign prostatic hyperplasia)? I also need your advice on red meat and groundnuts; is groundnut not good for the prostate especially with regards to BPH. At times, I love eating groundnuts with bananas. And about red meat, does it include the entrails like the liver, intestine, towel and particularly the skin, aka kpomo? I love eating these areas of the cow, especially kpomo. Does it affect the prostate with regards to BPH like the red meat itself? I am 72 years old and I hope to get your response early as usual. 090650****
God bless you, sir, for your prayers and questions. Broadly speaking, red meat is simply that meat that appears red when it is raw and it is found in beef, pork, goat, veal and mutton. Of these, goat meat is probably the least harmful. So, it does not include those entrails you mentioned in your question like the skin and intestines. And kpomo probably has the least nutritional value in the entire animal. If you enjoy eating it, therefore, there is no reason for you to stop doing so at this point. Secondly, these parts of the cow have no effect for good or ill on the prostate. The same thing can be said for groundnuts; all nuts are good for your body especially due to the minerals and micronutrients that they supply to the body. Therefore, in addition to groundnuts, you can also take cashew nuts, almond nuts, walnuts, tiger nuts, pea nuts and pistachio. As for soursop, it has a huge potential to fight against certain cancers but the information about its leaves is less clear. Perhaps an alternative medicine practitioner may be able to guide you here. Hanging balls have no connection to whatsoever might be going on with the prostate. The balls hang due to the loss of elasticity associated with advancing age.
Dear doctor, what can I do to have a huge cucumber-like-shaped penis? 08123***
I am not aware that there is anything you can do medically to gain the dimension to your penis as you have indicated above. In the meantime, you need to be well advised that even cucumbers have various sizes and some are hardly bigger than fingers on the human hand. There are many claims in the newspapers and magazines and even online by individuals and organisations claiming to have products that can help you achieve these sizes but they are mostly false claims and the benefit in the end is dubious.
Dear doctor, I have a lot of rashes over my body and I dreamt that somebody was telling me that those rashes could be a symptom of skin cancer. Please what do I do? Even my chest and the two sides over the ribs are paining me seriously and I feel hot inside me with headache also; in fact, general body pains. 090207****
Well, you did not provide a timeline regarding how long you have had these rashes. However, that alone is not likely to signify that you now have cancer of the skin. In fact, skin cancer will not cause rashes to be all over your body like this but will instead concentrate on a small area. It is very likely that what you actually have are heat rashes. The hot feeling you have inside and the chest pain are most probably due to something else not related to the rashes. So, your best bet is to go to a hospital and see a doctor.
Dear doctor, my elder sister, who is in her mid-fifties, has had intense itching for the past three months. It affects her private parts (labia majora), anus and ears (the pinna). It only subsides when she applies Epiderm cream but gets worse when she bathes. Please, what can be done to cure this embarrassing condition and what is the cause? 08124*****
Well, a dry skin due to hormonal changes around menopause can cause this sort of disturbance. Local heat or wetness can also be responsible for a problem like this but so also can a reaction to certain soaps, powder, tissue paper and clothing materials. She should see a doctor who will take her through all these possibilities until a likely cause is found. That way, she can ultimately be treated. Sometimes, if the skin is too dry and these kinds of issues erupt, all that is required is adequate moisturisation of the skin and the problem will be resolved.
Dear doctor, thank you for educating the Nigerian populace in Sunday PUNCH. May Allah bless your endeavours. Amin. Please sir, what drug is effective for sneezing, nasal obstruction (catarrh), and headache aside from Mixagrip and Procold because of their side effects like liver damage, insomnia, gastrointestinal disturbance, etc? kadiriismail
A medication such as Loratadine is safe, cheap, does not cause drowsiness or cause liver damage and is taken conveniently once a day is a good alternative to a couple of medicines you named. It can also be obtained across the counter.
Dear doctor, about 10 days ago, my eight-year-old son developed a fever. He also complained of headaches and could not eat. We started him on Lonart with paracetamol. After completing the treatment, he was still running a temperature and complaining of stomach pain. We took him to a private hospital where they did some tests for him and told us he had malaria and blood infection. Then they did urinalysis for him and I will share his results with you. They started him on another set of anti-malarial medication and Augmentin. He has been using the medicines now for the past two days and there is no improvement. He will complain of stomach pain and vomit afterwards. What do we do, please? 08139****
My candid advice for you is to take this boy to a public hospital. Persistent abdominal pain such as this associated with fever and vomiting indicates that his problem is far more serious than malaria. The urinalysis result you showed is very normal. It is not common to see young boys suffer from urinary tract infections. This kind of abdominal pain demands an X-ray to be done and an abdominal scan also. This patient was finally admitted at one of the general hospitals in Lagos where all the above suggestions were adhered to and he was placed on intravenous antibiotics while a tube was passed through his nose into his stomach). He is improving gradually.
