GI Risks from NSAIDs: What You Need to Know About Stomach Damage and Safe Use

When you take an NSAID, a nonsteroidal anti-inflammatory drug used for pain, fever, and inflammation. Also known as non-opioid pain relievers, these drugs include common names like ibuprofen, naproxen, and aspirin. They work by blocking enzymes that cause swelling and pain—but they also shut down the protective lining in your stomach. That’s why GI risks from NSAIDs are one of the most common and dangerous side effects you won’t hear about until it’s too late.

Every year, over 100,000 people in the U.S. end up in the hospital because of NSAID-related stomach bleeding. Even people who take them just once in a while aren’t safe. The damage doesn’t always come with warning signs like heartburn or nausea. Sometimes, it just shows up as weakness, dizziness, or black stools—by then, it’s already serious. People over 60, those with a history of ulcers, or anyone on blood thinners are at higher risk. But so are healthy 30-year-olds who pop ibuprofen for back pain every weekend.

These drugs don’t just hurt your stomach—they interfere with your body’s natural defenses. The stomach lining produces mucus and bicarbonate to shield itself from acid. NSAIDs block the enzymes that make those protective substances. Without them, stomach acid eats away at the tissue, leading to ulcers, perforations, or life-threatening bleeding. That’s why doctors often prescribe proton pump inhibitors, medications that reduce stomach acid to protect the GI tract alongside NSAIDs for long-term users. But even that isn’t foolproof. Some people still bleed, even on PPIs.

And it’s not just about dosage. It’s about timing, combination, and your overall health. Taking NSAIDs with alcohol? Higher risk. Using them with corticosteroids? Double the danger. Even low-dose aspirin, often thought of as safe for heart health, can cause GI bleeding. The truth is, there’s no truly safe NSAID—only safer ways to use them.

You don’t have to live with pain or avoid NSAIDs entirely. But you do need to know your limits. How often are you taking them? Are you using the lowest dose that works? Have you talked to your doctor about alternatives like acetaminophen, physical therapy, or topical treatments? The posts below break down real cases, warning signs you can’t ignore, how to spot early damage before it’s an emergency, and what to ask your pharmacist when you pick up your next bottle. These aren’t theoretical risks—they’re happening to people right now, every day. And you can protect yourself if you know what to look for.