The short answer:
Too much ibuprofen has been known to cause stomach pain as a result of the inhibition protective prostaglandin formation. For stomach pain with too much ibuprofen, you should avoid taking ibuprofen on an empty stomach, stop smoking, stop or limit your alcohol consumption, and take antacids or proton pump inhibitors with ibuprofen.
- Ibuprofen is a commonly used painkiller that belongs to the nonsteroidal anti-inflammatory drug (NSAIDs).
- It acts by inhibiting the production of prostaglandins by blocking the cyclooxygenase enzyme (COX-1 and COX-2 enzyme).
- Stomach pain is a common side effect of ibuprofen, it is attributed to the action of ibuprofen that blocks the production of the protective prostaglandin that provides protection to the stomach lining by increasing the gastrointestinal blood flow and decreasing acid secretion.
- In case you are experiencing stomach pain with too much ibuprofen, you have to stop taking it and ask your doctor in case of other symptoms such as stomach bleeding.
- To avoid stomach pain with ibuprofen, you should avoid taking ibuprofen on an empty stomach, stop smoking, stop or limit your alcohol consumption, and take antacids or proton pump inhibitors with ibuprofen.
- Other side effects of too much ibuprofen are nausea, vomiting, rebound headache, kidney injury, liver disease, and increased risk of cardiovascular diseases.
Why ibuprofen cause stomach pain?
Ibuprofen is a pain killer that belongs to a group of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs).
Ibuprofen similar to other NSAIDs works by the production of prostaglandin through inhibition of cyclooxygenase enzyme (COX) that is responsible for the conversion of arachidonic acid into prostaglandins. There are two types of cyclooxygenase enzymes known as COX-1 and COX-2. They represent targets of NSAIDs.
Ibuprofen and other NSAIDs are able to competitively inhibit both COX-1 and COX-2.
The action of COX-1 and COX-2 on the arachidonic acids leads to the formation of four bioactive prostaglandins including prostaglandin E2 (PGE2), prostacyclin (PGI2), prostaglandin D2 (PGD2) and prostaglandin F2α (PGF2α).
Prostaglandin E2 (PGE2) is produced during inflammation, and the increased levels of PGE2 help mediate some of the cardinal features of inflammation, including pain, edema, and fever (Ref).
The gastrointestinal mucosa contains large amounts of prostaglandins. Prostaglandin PGE2 present in the gastric mucosa affects gastric mucosal blood flow and acid secretion. Prostaglandins have been shown to provide protection against gastric and duodenal mucosal damage in animals and humans. This protection can occur independently of acid inhibition and may be direct or adaptive (Ref).
The protective effect of prostaglandin on the gastrointestinal mucosa can occur through the following mechanism:
- PGE2 are potent inhibitors of gastric secretion
- They are potent vasodilators in the mucosa. Therefore, they help to increase blood flow to the gastrointestinal mucosa.
The inhibition of prostaglandin formation by ibuprofen and other NSAIDs leads to:
- Reduce the pain as a result of reducing the production of prostaglandin responsible for pain.
- Too much ibuprofen is found to induce stomach pain due to stomach irritation which is referred to as heartburn.
- Decrease the blood flow to the gastrointestinal mucosa due to the inhibition of prostaglandins responsible for vasodilation and blood flow to the gastrointestinal mucosa.
- Damage of the gastrointestinal mucosa due to the reduction of PGE2 which provides protection of the gastrointestinal mucosa.
- In severe cases, it can damage the stomach lining leading to ulcer formation. Moreover, in certain cases, it can lead to erosion that leads to intestinal bleeding which can be life-threatening.
- Furthermore, stomach perforation (a hole in your stomach) can result in rare cases.
Accordingly, too much administration of ibuprofen can induce stomach pain, irritation, and also stomach ulcers can result.
What is considered too much ibuprofen?
If a child ingests less than 100 mg/kg of ibuprofen, they may not experience any symptoms of an overdose. At a dosage of 400 mg/kg, however, a child may experience serious and life-threatening side effects.
The maximum dose of ibuprofen is 800 mg per dose while the maximum daily dose is 3200 mg per day (prescribed dose) while 1200 mg per day is the maximum over-the-counter dose.
In case you take a dose of ibuprofen greater than the maximum daily dose or a daily dose of ibuprofen, serious health outcomes can result.
What are the symptoms of too much ibuprofen?
Too much ibuprofen can lead to the following:
- Gastrointestinal complications such as stomach pain (heartburn), ulceration, bleeding, and perforation (stomach or intestinal perforation.
- Rebound headache
- Ringing in their ears (tinnitus)
- kidney injury that leads to kidney failure
- Liver diseases
- Cardiovascular adverse effects such as heart failure, heart disease, and stroke,
What to do with stomach pain after too much ibuprofen?
Stomach pain is one of the main symptoms that result from too much ibuprofen and also it is reported as a common side effect of long-term use of ibuprofen.
For stomach pain with too much ibuprofen, you have to do the following:
- Stop taking ibuprofen immediately
- You must call your doctor immediately if you have severe abdominal pain or bloody stool.
How to avoid the stomach side effects of too much ibuprofen?
Gastrointestinal side effects such as stomach pain are among the common side effects of too much ibuprofen.
In order to avoid the stomach pain associated with ibuprofen, you have to do the following:
- You should stop taking ibuprofen after too much dose of ibuprofen
- Avoid taking ibuprofen on an empty stomach.
- Take ibuprofen after a full meal with a glass of water
- You can take antacids with ibuprofen
- Stomp or limit alcohol intake that can increase stomach irritation
- Stop smoking which can aggravate stomach pain
- You can ask your doctor to switch to selective COX-2 inhibitor painkillers such as. these medications work by selectively inhibiting cyclooxygenase 2 enzymes that are responsible for the production of prostaglandins that induce pain. However, selective COX-2 inhibitor doesn’t affect the production of protective prostaglandins that protect the gastric mucosa.
- Drugs that reduce stomach acidity such as proton pump inhibitor (omeprazole) are effective in reducing the gastrointestinal complications that can result from ibuprofen administration. These drugs can reduce your risk of ulcer formation and further intestinal bleeding.
- You can alternate to Vimovo which contains naproxen (Gastro-resistant) and esomeprazole (proton pump inhibitor) to protect your stomach.
How long does it take for ibuprofen to cause ulcers?
Gastric or duodenal ulcers with ibuprofen or other NSAIDs don’t likely to develop overnight. In contrast, it may take a few weeks or months with regular doses of ibuprofen.
Your risk of developing ulcers with ibuprofen increases with the following conditions:
- Age (the risk is higher with elderly patients)
- Previous history of ulcers
- In case you tested positive for H. pylori
- Taking ibuprofen with corticosteroids, and blood thinners
- Heavy alcohol consumption