In the world of medicine, it’s no secret that painkillers are a double-edged sword. The question is are painkillers killing more than your pain, could they be killing your good gut bacteria too? On one hand, they’re our “get out of pain” free card. Often allowing us to continue work, family commitments or just get on with our day. On the other hand, research is starting to show that we may not be getting out of pain for free at all. Painkillers and anti-inflammatories (often taken in conjunction with or included in the painkiller itself) are not only affecting our livers but our gut microbiome as well.

If you’ve been on my page for a while you’ll know our gut microbiome consists of a vast ecosystem of trillions of microorganisms living within our digestive system. It plays an extraordinary role in our overall health. Influencing everything from our digestion and immune system to our mental well-being. But what happens when we introduce painkillers into this intricate biological landscape? Let’s start by defining what painkillers are.

What are painkillers?

Painkillers, also known as analgesics, are a diverse class of medications primarily designed to ease pain and discomfort. They come in different forms, including over-the-counter (OTC) drugs and prescription medications, each with its own set of active ingredients and mechanisms of action. Here are the differences between OTC and prescription painkillers for you to identify:

1. Over-the-Counter (OTC) Painkillers:
   • Common OTC painkillers include drugs like Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen (e.g., Advil) and acetaminophen (e.g., Tylenol). These medications are readily available without a prescription, and they are often used for managing mild to moderate pain, reducing fever, and alleviating common discomforts like headaches, muscle aches, and menstrual cramps. Paracetamol was classified as the most commonly bought and used painkiller, according to NCBI.
     
2. Prescription Painkillers:
   • On the other hand, prescription painkillers are typically more potent and are meant for more severe or chronic pain conditions. These include opioids such as oxycodone, hydrocodone, and morphine. Opioids work by binding to specific receptors in the brain and spinal cord, effectively reducing pain perception. However, they also carry a higher risk of addiction and side effects, making their use closely monitored and regulated by healthcare professionals.

Prevalence of Painkillers:

Dr Kirsten Becker commented on how alarmed she is at just how many people ages 6 – 96 use painkillers daily. It seems like painkillers really are the pill for every ill. This includes both OTC painkillers and prescription painkillers, with the scarier side effects being from prescription painkillers. For a graphic depiction of just how harmful they can be, I recommend Painkiller on Netflix since we’re focusing on their effects on gut health today instead.

Short-Term Effects on Gut Health

It’s essential to acknowledge that pain relief doesn’t come without potential side effects and risks, especially in the short term. Here are some of the key concerns:

1. Gastrointestinal Issues:
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, which are commonly used as painkillers, can irritate the lining of the stomach and intestines. This irritation can lead to symptoms such as indigestion, gastritis, or stomach ulcers. In some cases, this can result in gastrointestinal bleeding, which can be a severe and potentially life-threatening issue.
2. Liver Damage:
   • Some painkillers, such as acetaminophen (paracetamol), are metabolized in the liver. When taken in excessive doses or in combination with alcohol, they can potentially harm the liver, leading to conditions like liver toxicity or failure. It’s crucial to follow recommended dosages and avoid alcohol while using these medications.
3. Allergic Reactions:
   • While rare, individuals can experience allergic reactions to painkillers. Symptoms may range from mild skin rashes and itching to severe anaphylactic reactions, which are life-threatening emergencies. Be aware of any allergies and consult a healthcare professional if you suspect an adverse reaction.

The reason I’m personally cautious of painkillers:

My primary concern came from this UK article: “Opioids can slow the whole digestive tract’s motility (the movements inside the gut). Reduced motility is one of the root causes of constipation and other symptoms of opioid-induced bowel dysfunction (abnormal functioning of the gut)”. This is where we get into the crux of what the title of this article is about. If we are reducing our gut motility, we’re running the risk of harming or killing off some of the essential gut bacteria we need to thrive.

A list of potential and harmful effects of painkillers

1. Disruption of Gut Microbiota: Painkillers can disrupt the balance of the gut microbiota, leading to dysbiosis. Dysbiosis refers to an imbalance in the types and quantities of microorganisms in the gut, which can result in the overgrowth of harmful bacteria and a reduction in beneficial bacteria.
2. Leaky Gut Syndrome: Some painkillers, primarily prescription painkillers, have been associated with an increased risk of developing a leaky gut syndrome. This condition allows substances that should remain in the intestines to leak into the bloodstream, potentially leading to inflammation.
3. Gut Inflammation: Painkillers can contribute to gut inflammation. Chronic use of prescription painkillers can irritate the gastrointestinal tract, leading to inflammation and potential damage to the gut lining.
4. Altered Gut Immune Response: The gut microbiome regulates the immune system. Painkillers can impact the gut’s immune response, potentially leading to an imbalance in regulating inflammation and immune function.
5. Reduced Diversity: Prolonged use of painkillers, especially opioids, has been associated with a reduction in the diversity of the gut microbiome. A diverse microbiome is associated with better overall health, while reduced diversity can be linked to various health issues.
6. Constipation: Opioid painkillers are well-known for their side effect of constipation. Chronic opioid use can lead to severe constipation, which can impact the gut microbiome by altering the transit time of food through the intestines.
7. Increased Risk of Infection: Disruption of the gut microbiota can make individuals more susceptible to gastrointestinal infections. This is because a balanced gut microbiome is a barrier against harmful pathogens.
8. Impaired Nutrient Absorption: The gut microbiome plays a role in nutrient absorption. Changes in the gut microbiome can affect the absorption of essential nutrients, potentially leading to nutrient deficiencies.

The surprising side effects of reduced motility:

You might think constipation is just not being able to have your regular number two ;). Did you know that you could be pooping every day and still be constipated? More than that, symptoms like weight gain, fatigue, severe PMS, low sex drive, low mood, and even anxiety have all been correlated with too much o-estrogen. This might occur during constipation because we cannot get rid of the excess o-estrogen, which is reabsorbed as a result.

Before you get too scared:

There is a crucial role for modern medicine in the world. I genuinely believe doctors are doing the best they can with the resources they have. Know that these side effects depend on the dosage, type, and duration. Using the occasional painkiller is safe for most people. But I am passionate about highlighting that it’s more important now than ever to stop using medicine as a “band-aid” for what’s truly happening. At the Gut Health Agency, we focus on getting to root causes instead of providing temporary fixes. I’d also love to show you some of the lifestyle interventions women can try instead of (or in conjunction with) painkillers to manage their pain.

Try these first before reaching for the painkillers:

1. Regular Exercise: Meet endorphins, the body’s natural pain relievers. Walking, swimming, yoga, and stretching can improve flexibility, strengthen muscles, and reduce pain in conditions like arthritis or menstrual cramps. (Plus, I ALWAYS feel better after moving my body)
2. Diet and Nutrition: A balanced diet rich in anti-inflammatory foods can help manage chronic pain conditions. Foods with omega-3 fatty acids, antioxidants, and whole grains can reduce inflammation and relieve pain. Avoiding or minimizing processed, inflammatory, and sugary foods can also make a significant difference.
3. Stress Management: Chronic stress makes everything worse – pain is no exception. Techniques such as mindfulness meditation, deep breathing exercises, and yoga can help manage stress and reduce pain. Managing stress has been particularly beneficial for my clients suffering from tension headaches and fibromyalgia.
4. Acupuncture: This alternative therapy helps the body to alleviate pain and improve overall well-being. Acupuncture has been found effective for conditions like chronic pain, migraines, and menstrual cramps.
5. Herbal Remedies: Here at The Gut Health Agency, we’re all about food first and taking the natural route. We’ve found some women gain incredible relief from pain through herbal remedies like ginger, turmeric, or white willow bark. These natural options may provide anti-inflammatory and pain-relieving effects, too! We’re also huge fans of Hilma TENSION RELIEF for those days when that stubborn headache won’t go away. Use code GUTHEALTH20 for 20% off all Hilma products!
6. Lifestyle Swops Simple lifestyle changes, like posture, hydration, quitting smoking, and sleeping enough, cannot be underestimated for pain relief and helping deal with the root issue.

Clear is kind:

My go-to saying for my team and clients is that “clear is kind.” The best way to make a good choice is to be informed of the effects AND all your options. I do hope you’ll give these natural routes a try next time you’re experiencing pain. Most importantly, I hope you’ll take a second to ask WHY. To breathe into the pain, listen to your body and try to see what it is you truly need. This connection is invaluable and is another benefit of working with someone who is dedicated to YOU healing you.

Stay informed loves

xx

Chelsea.