Blocking Inflammation, Blocking Healing?

What NSAIDs Really Do

Every day we're fed conflicting messages about what's healthy and what isn't. It's easy to lose track of what actually benefits your body and what makes your health worse over time. We often minimize what we do daily, and over estimate what we expect to happen when we start to correct bad habits.

In general, expecting your digestion to be well after a week of eating more fiber is not realistic. When I say this, understand that I am a human being with habits that sneak in, too. Living with chronic pain, I sometimes DO have to rely on NSAIDs , and that affects my own digestion. I ride this roller coaster myself when a bad pain flare up occurs.

Here are 5 different areas of digestion that REALLY take a hit with regular use of NSAIDs.

1. Damage the stomach lining and cause ulcers

NSAIDs block enzymes called COX-1 and COX-2, reducing prostaglandins. Prostaglandins help protect the stomach by stimulating protective mucus and bicarbonate, maintaining blood flow to the stomach lining, and supporting tissue repair. When these protective mechanisms are suppressed, the stomach becomes more vulnerable to:

• Iirritation

• Gastritis

• Erosions

• Peptic ulcers. Severe ulcers can bleed or perforate.

2. Increase intestinal permeability (leaky gut)

NSAIDs can disrupt the intestinal barrier, particularly in the small intestine. They may:

• Damage intestinal epithelial cells

• Disrupt tight junctions that help maintain the gut barrier

• Increase exposure of underlying tissue to bacterial products and other luminal substances.

This can contribute to intestinal inflammation and increased permeability. 80% of the immune system lives in the large intestine. This part of your digestion affects EVERYTHING about your health.

3. Trigger small intestinal inflammation and damage

NSAIDs can cause a condition known as NSAID enteropathy, which can involve:

• Small intestinal inflammation

• Erosions and ulcers

• Occult intestinal bleeding

• Protein loss and, in more severe cases, iron-deficiency anemia

This damage may occur even when someone has no obvious stomach symptoms. In some cases, long-term use can cause diaphragm-like strictures, which are narrowings in the small intestine.

4. Disrupt the gut microbiome

NSAIDs can alter the composition and activity of intestinal bacteria. They may:

• Change the balance of beneficial and potentially harmful microbes.

• Interact with bacterial metabolites and bile acids.

• Contribute to intestinal barrier damage and inflammation.

This relationship works in both directions: the microbiome can influence NSAID-related intestinal injury, and NSAIDs can change the microbial environment. The long-term clinical significance of these changes is still being studied.

5. Worsen digestive symptoms and aggravate existing intestinal disease

NSAIDs can cause or worsen:

• Abdominal pain and cramping.

• Nausea and indigestion.

• Diarrhea or constipation.

• Intestinal bleeding and inflammation.

In people with inflammatory bowel disease (Crohn's disease or ulcerative colitis), NSAID use has been associated with symptom flares in some studies. The evidence is mixed, but people with IBD are often advised to avoid routine NSAID use unless their treating clinician recommends it.

DO THIS INSTEAD

Omega-3 fatty acids

EPA and DHA, found in fatty fish and certain supplements, influence inflammatory signaling and the production of inflammation-resolving molecules. Adequate omega-3 intake may help some people with inflammatory joint conditions, although it is not a universal pain treatment.

For the supplement form, I've put together a recommended protocol on Fullscript. Shop my Fullscript recommendations here.

Magnesium and nutrient sufficiency

Magnesium supports normal muscle and nerve function. Getting enough magnesium through foods such as pumpkin seeds, spinach, legumes, and nuts can help prevent deficiency-related muscle symptoms. Supplementation is most useful when intake is inadequate or deficiency is present, rather than as a general painkiller.

Turmeric and curcumin

Curcumin, a compound in turmeric, has been studied for its potential to reduce pain and inflammation, particularly in osteoarthritis. Turmeric in food is a simple addition, while concentrated supplements may interact with medications. It is important to choose a supplement carefully.

Ginger

Ginger contains bioactive compounds that have been studied for their anti-inflammatory and pain-relieving properties. Ginger can help reduce osteoarthritis pain and muscle soreness. Adding fresh ginger to meals, teas, or smoothies is an easy way to incorporate it. Concentrated supplements may offer different effects and can interact with blood thinners or cause digestive irritation in some people.

Three of the foods I just recommended — omega-3 sources, turmeric, and ginger — are part of a free guide I put together. Seven real foods that fight inflammation. Familiar foods, easy to add to what you're already making. If this is where you want to start, it's a practical place to begin.

A Final Thought

Your Mind, the Limbic System, and Pain

Your brain plays a powerful role in how you experience pain. The limbic system, which is involved in emotions, stress, memory, and threat detection, communicates with the brain's pain-processing networks influencing how intensely pain is felt. Fear, anxiety, chronic stress, and negative expectations can amplify pain signals, while feelings of safety, relaxation, and positive emotional experiences can help reduce pain sensitivity. This doesn't mean pain is imaginary or all in your head. It means your nervous system and emotional state can turn the volume of pain up or down, making stress management, mindfulness, and emotional well-being valuable parts of a comprehensive pain-management approach. If you’d like to explore this further, book a free discovery call.