If medicines like Ibuprofen are anti-inflammatory, why do they inflame the digestive system?


Question:
With NSAIDs you are advised to take them with food as otherwise they will eat through your stomach, which seems contradictory to me.

Answers:
DRUG CLASS AND MECHANISM: Ibuprofen belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Other members of this class include naproxen (Aleve), indomethacin (Indocin), nabumetone (Relafen) and several others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. Prostaglandins are chemicals that are made by the body and are responsible for causing pain, fever and inflammation. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved ibuprofen in 1974.

DRUG INTERACTIONS: Ibuprofen is associated with several suspected or probable interactions that can affect the action of other drugs. Ibuprofen may increase the blood levels of lithium (Eskalith) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity. Ibuprofen may reduce the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure. When ibuprofen is used in combination with aminoglycosides (e.g., gentamicin) the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycosides from the body is reduced. This may lead to aminoglycoside-related side effects. Individuals taking oral blood thinners or anticoagulants (e.g., warfarin) should avoid ibuprofen because ibuprofen also thins the blood, and excessive blood thinning may lead to bleeding.

SIDE EFFECTS: The most common side effects from ibuprofen are rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation and heartburn. Ibuprofen may cause ulceration of the stomach or intestine, and the ulcers may bleed. Sometimes, ulceration and bleeding can occur without abdominal pain, and black tarry stools, weakness, and dizziness upon standing (orthostatic hypotension) may be the only signs of a problem. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously. People who are allergic to other NSAIDs, including aspirin, should not use ibuprofen. Individuals with asthma are more likely to experience allergic reactions to ibuprofen and other NSAIDs.
if i remember (its been awhile and im doing this out of my head not from a reference so double check me if youre doing this for school or something) right they block an enzyme called COX which is involved in making prostaglandins which are chemical signals involved in pain, but also have a protective function of regulating the lining of the digestive tract to protect your stomach from acid and enzymes. since they are involved in both functions, the drugs block both the protective effect and the pain/inflammatory effects, which means the GI lining is weakened and more susceptible to stomach acid, pepsin, and other digestive enzymes which increases risk for ulcers. selective NSAIDS like celebrex and vioxx block mainly just the pain players and dont reduce the protective prostaglandins as much so they have lower incidence of GI effects

and also the drug itself is somewhat irritating which is why they say to take them with food.
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