# Advil vs. Tylenol vs. Alleve



## My Butt Hurts (Jun 22, 2008)

What do you take as a pain reliever?  Is there anything that we Crohnies should NOT take??
I swear that years ago my GI (since retired) told me not to take Advil (ibuprofen), but I don't know if it didn't mix with sulfasalazine, or if it was a Crohn's thing.  I usually take Tylenol (acetaminophen) for pain relief (for girly cramps).  I just started taking Alleve (naproxen sodium) for cramps the past few months.  It works great!

So does anyone know?  Can we take these? What do you take?

Sheesh - too many parentheses.
(Sorry) :ylol2:


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## katiesue1506 (Jun 22, 2008)

Hey,

I was told not to take anything processed through the stomach. Which leaves you with Tylenol. Aleve is really hard on the stomach and can be ulcer producing. Tylenol is processed through the liver, which is what makes it okay to take.

Although with everything else we take, seems like we'd wanna avoid trashing the liver any more than we are... but hey, what do I know.

p.s. Aleve is wonderful, sometimes I cheat and take one here or there... they are awesome. Though I have found that Tylenol arthritis is a really good pain killer too.


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## Wiles (Jun 22, 2008)

My doctor told me to stay away from anything that thins the blood (like aspirin). I sometimes take tylenol, but I find it doesn't really help a lot when I've had bad days.


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## butt-eze (Jun 23, 2008)

I was told tylenol (acetmetophin) only.  The others are not good for my stomach.  I hope this helps!


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## Jeff D. (Jun 23, 2008)

Yeah I only take tylenol.  Theo others are harsh on the intestines.


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## Guest (Jun 23, 2008)

my first port of call when in pain is always paracetamol (i think the same as tylenol..?), sometimes i will take a paracetamol/codeine preparation, or Syndol which has paracetamol & other ingredients (not sure what). i also top it up with ibruprofen if the pain is bad - this doesn't seem to have adverse effects on me. i never take aspirin. i have tramadol tabs here for severe pain, but rarely turn to them. i also have voltarol dispersible, which again is for severe pain, and i am fine taking that when absolutely necessary.


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## Colt (Jun 23, 2008)

The official rule is that cox-inhibitors (NSAIDS) are contraindicated (meaning it's a medication error to administer it without special permission) for Crohn's disease. They trigger ulceration and flares.

I don't have the link but about a week ago I was reading about a study about NSAIDs and Crohn's. It was a Finnish study and they compared short-term (2 weeks) use of Aspirin and Ibuprofen (Advil/Motrin) against the control of Acetaminophen (Tylenol). 

Ibuprofen (like naproxen) inhibits cox-1 and cox-2 enzymes.
Aspirin inhibits cox-2 only.
Acetaminophen does not inhibit either.

Ibuprofen had the expected results and put a bunch of people into flares.
The Aspirin group had 0 flares.
The Acetaminophen group had 1 flare (likely unrelated and random).

It was decided that even short term use of duel-cox-inhibitors has unacceptable side-effects. Use of cox-2 only inhibitors though were recommended to be removed from contraindication for short term and low-dose use. This opens up crohn's patients to aspirin use for heart conditions.

By the way, Naproxen is duel-cox-inhibitor and has the same effect as ibuprofen. Most arthritis meds are also duel-cox-inhibitors. Sadly inhibiting both enzymes is exactly why they are so much more effective than aspirin and acetaminophen. I've found that arthritis meds do wonders for my rather agonizing joint pain but every time I take them my body becomes ulcer city. It's torture. Here's a drug that I know works for me for my most annoying symptoms on a daily basis and I can't take the drug because it makes my other symptoms really bad.


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## My Butt Hurts (Jun 23, 2008)

Wow!  I thought this was almost a dumb question.  Glad I asked - thanks for the replies!
Tylenol it is then!
Oh Aleve, how I will miss you.....


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## Kittee (Jun 23, 2008)

Yep I only use Tylenol. Doctors orders.
Which rather sucks when a migraine hits. Because anyone with migraines will tell you that Tylenol is about like throwing a acorn at jet plane and expecting it to bring it down.


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## Jeff D. (Jun 23, 2008)

lol Kittee I know that feeling.  I think the tylenol makes them worse.


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## BWS1982 (Jun 24, 2008)

Same as Wiles, and some of the others: I was told no Aspirin, or Ibuprofen, for thinning blood reasons, along with intestinal rebellions. I use tylonel, and it seems to work some for cramping, as I'm not a heavy user of pain meds, I almost never get headaches or pains (non-Crohns), I've always been that way.

Good info Colt.


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## Ace (Jun 25, 2008)

as with Pen, the only thing i take is percocet or just straight oxycodone, i don't need much usually just 1/2 a tab and buy does it ever work it also slows the diarea down and gives some malor relief my family doc is really good he has his bacelours of pharmacuticals and he is the local anesteseolosist in our town, he has taken me off the perks because he is worried about my liver but if my joints r hurting i'll take those over the oxy.  narcotics do suck big time but if you need them you need them, as taboo as it all is.

peace!


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## Reese1603 (Jul 8, 2008)

I was told not to take anything but tylenol because its really harsh on your stomach. 

HOWEVER, tylenol doesn't help me one bit, so usually I just go without. When the pain is super super bad (I get bad back aches due to a car accident a year and a half ago) I still sneak in an Advil every now and again. (shhhh...don't tell my doc!)


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## Reese1603 (Jul 8, 2008)

Kittee said:
			
		

> Yep I only use Tylenol. Doctors orders.
> Which rather sucks when a migraine hits. Because anyone with migraines will tell you that Tylenol is about like throwing a acorn at jet plane and expecting it to bring it down.



OMG I love your analogy! That's exactly how I feel!


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## pb4 (Jul 8, 2008)

Alieve, Advil and all other aspirin type meds that contain NSAIDs are to be avoided by IBDers because it promotes bleeing in the bowels, any good GI will warn their patients of this.

Tylenol is the safe bet.


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## ericajones80 (Jul 11, 2008)

cant go wrong with Tylenol


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## Isla (Jul 11, 2008)

My doctor didn't tell me to avoid IBProfen... should I still avoid it?


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## Colt (Jul 13, 2008)

Isla said:
			
		

> My doctor didn't tell me to avoid IBProfen... should I still avoid it?


Ibuprofen increases ulceration and will trigger flares for chronies. Pretty much all of the non-prescription NSAIDs other than Aspirin are no good. Aspirin, as I posted earlier, is cleared for usage of less than 8 weeks. Acetaminophen (Tylenol) works in a completely different way to relieve pain so it's fine to take.


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## milesrlv (Jul 13, 2008)

I was told to avoid NSAIDS and found out the hard way. I was told Tylenol is okay or aspirin (aspirin unless on blood thinners.) The Ibuprofen caused a serious case of cramps and bleeding. While in the hospital after this incident was when I was told about this. Also there is an ingredient in most sugarless gums (I believe it's only sugarless) that causes a similar problem. I don't remember off hand.


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## Colt (Jul 15, 2008)

Aspartame? Oddly enough I have an adverse reaction to it as do many people. I inherited it from my mother. I get severe migraines from even trace amounts. I wouldn't know about its affect on crohn's because I don't consume it but I certainly have a nightmare of a time finding gum that I can chew. They don't really even have regular sugar gum anymore. Just a few brands and they're all kids' stuff like bubble tape.


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## My Butt Hurts (Jul 15, 2008)

Colt - if you're looking for full sugar gum, 3 popular brands are Bubble Yum, Hubba Bubba, and Bubblicious.  They all have sugar and no aspartame unless it says sugar free.  You can find all of those in the checkout aisle of grocery stores, Target/K-Mart/Wal-Mart, gas stations or those 24-hour convenience stores.
I'm a big gum chewer, none of that fake sugar gum for me.  I still have some bubble gum eggs from Easter.  Yum!


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## Isla (Jul 15, 2008)

It is nearly impossible for me to chew gum, after a few initial chews I just swallow it. Especially those sugar gums - I eat that stuff like candy. My new thing is the Ice Breakers mints but they have aspartame in them. But I especially use them to get my extra vitamins. The kind I use is restore - has vitamins A, C, E, and zinc.


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## choko (Jul 15, 2008)

Isla said:
			
		

> My doctor didn't tell me to avoid IBProfen... should I still avoid it?


Hi there, i used to be on the forum's as jodes but due to being ill i forgot my user name so had to change it, anyway i think you should not take any thing with NSAID,s in it even if your doc hasn't told you to he or she may think you already know not to. My GP expected me to know not to. One of the pain reliever's i take is panadol-osteo which is great, that is what it is called here in aussie land, you may have to go on mayoclinic to see what it is over there. By the way the picture you have posted is really beautiful.


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## Isla (Jul 15, 2008)

Thank you, my doctor is reluctantly treating me for Crohns.. as the blood serum test came back positive for Crohns but my colonoscopy and pill camera came back just fine. I think he is giving me the Asacol to placate me. As long as I am getting treated, frankly I don't care what his motivations are 

And thanks for the compliment on the picture.


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## milesrlv (Jul 15, 2008)

Colt said:
			
		

> Aspartame? Oddly enough I have an adverse reaction to it as do many people. I inherited it from my mother. I get severe migraines from even trace amounts. I wouldn't know about its affect on crohn's because I don't consume it but I certainly have a nightmare of a time finding gum that I can chew. They don't really even have regular sugar gum anymore. Just a few brands and they're all kids' stuff like bubble tape.


No it isn't aspartame although that makes me ill as well but not in the same way. It is sorbitol/mannitol (sugar alcohol) that stuff is an instant trigger for me. I have not been able to find a gum other than bubble gums that don't have one of these or some similar sugar alcohol in them.


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## BWS1982 (Jul 16, 2008)

Hey Colt, not making an argument one way or another, I'm simply asking because I don't know, but if aspirin is cleared for 8 or fewer weeks of usage, then I assume it should take several weeks to thin the blood out considerably. My question then, based on the pretense of this assumption, is then why is one single dose given to heart attack victims, as that itself is known to save lives during a heart attack, isn't it, to take it DURING the cardiac arrest? Is there something I'm not getting?


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## Isla (Jul 16, 2008)

Well Benson is that why we bleed on NSAIDs? Because of the blood thinning quality?


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## Isla (Jul 16, 2008)

> In the European study, researchers led by Ingvar Bjarnason, M.D., of Sahlgrenska University Hospital in Gothenburg, Sweden, tried to tease out exactly how NSAIDs contribute to disease flares in the people with IBD.
> 
> 
> The researchers enrolled 209 patients with quiescent Crohn's disease and ulcerative colitis in a two-part study. In the first part, 109 patients were given either the non-NSAID acetaminophen, or the conventional NSAIDs, naproxen, diclofenac, and indomethacin, over a four-week period, and monitored for relapse. The acetaminophen group served as a control.
> ...


http://www.medpagetoday.com/Gastroenterology/InflammatoryBowelDisease/tb/2616


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## Colt (Jul 16, 2008)

BWS1982 said:
			
		

> Hey Colt, not making an argument one way or another, I'm simply asking because I don't know, but if aspirin is cleared for 8 or fewer weeks of usage, then I assume it should take several weeks to thin the blood out considerably. My question then, based on the pretense of this assumption, is then why is one single dose given to heart attack victims, as that itself is known to save lives during a heart attack, isn't it, to take it DURING the cardiac arrest? Is there something I'm not getting?


Aspirin isn't Warfarin. It's blood thinning effect is small. Especially with only a small number of doses. The reason a double dose of aspirin is given for heart attacks is that it works quickly and it's good to have something in your system before your heart stops. Warfarin is really slow and heparin needs to be injected so you need to be in the hospital to get it.

The main issue with crohn's and NSAIDs has always been concerns over increased ulceration.


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## pb4 (Jul 16, 2008)

The way I've always understood it is taking an aspirin a day for those with heart issues can keep attacks at bay because it acts like a blood thinner which aids in the blood thickening/clotting in the heart resulting in heart attacks.  Of course it's not a guaranteed method for those with heart disease but it's apparently a good means of lowering the risk...I'd hate to be an IBDer with heart problems too, that's for sure.


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## Isla (Jul 16, 2008)

Well, I don't have "active flare", so taking an ibuprofen here and there isn't going to hurt me or cause me to flare. I don't know about the rest of you - but by the research I have done with studies done in the past 5 years I am going to go ahead and use it. I don't use the stuff really unless I have a migraine - the prescription stuff works like a charm!


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## BWS1982 (Jul 17, 2008)

That's the main reason I was told no aspirin by several GI's.


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## Colt (Jul 17, 2008)

BWS1982 said:
			
		

> That's the main reason I was told no aspirin by several GI's.



They're either being over-cautious (a common trait in doctors and not necessarily a bad one) or you specifically have an especially high risk of bleeding uncontrollably. Either way, it doesn't really hurt you to follow that advice unless you're having a heart attack.


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## BWS1982 (Jul 17, 2008)

UNLESS? I'm confused now. I thought if I WAS hypothetically having a heart attack that'd be the best time to take aspirin, for blood thinning?

Anyways, thanks.


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## pb4 (Jul 17, 2008)

Lots of people take an aspirin a day to help keep heart attacks at bay, they've even mentioned it on commercials in the past....I don't know if it would be as affective if you only took it during a time when you think you're having an attack.


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## Colt (Jul 18, 2008)

Reread. It doesn't hurt you to follow that advice (of not taking aspirin) unless you're having a heart attack.

A good sized dose (650mgs which is the highest OTC dosage you can take being 2 325mg tabs) during a heart attack can help you. Especially if chewed and without a coating instead of swallowed. This is because it acts very very quickly. It's both available for most people when the heart attack begins and with heart attacks speed is essential because if your heart stops the medication can't circulate anymore. Also notice the dosage compared to the standard preventative 81mgs which isn't really harmful unless you have some special risk of heavy bleeding (and some of us do at times).


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## BWS1982 (Jul 19, 2008)

I get it now, been loopy lately from not sleeping well. Thanks though.


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## Colt (Jul 20, 2008)

Tylenol isn't an anti-inflammatory so it's notoriously worthless for inflamed joints.


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## hippie4lyfe (Feb 8, 2009)

omg i wish i read this earlier, i was stubborn and had a headache, now im bleeding.

no more advil, no more ibuprofen.


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