Gillian Martlew, N.D.

Vioxx™ was recently withdrawn by its manufacturer Merck & Co because of concern over cardiovascular risk side-effects. Celebrex™ and Aleve™ are now under investigation because research suggests that they may also be linked to an increased risk of cardiovascular disease. Researchers are suggesting that Aleve™ only be taken for 10 days, and that the recommended dose should not be exceeded.

The warnings about these drugs stem from a study by the National Institutes of Health (NIH). Researchers were studying certain antiinflammatory drugs in patients at risk for Alzheimer’s disease, but the studies were stopped early because the cardiovascular risks surfaced. It was a NIH study on hormone replacement therapy that caused HRT to be withdrawn. (See my article in this section on Hormone Replacement Therapy.)

Cox-2 inhibitors like Vioxx™, Celebrex™ and Bextra™ belong to a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs). Cox-2 inhibitors (a sub-group of NSAIDs) were widely prescribed because they were said to have less gastro-intestinal side-effects than aspirin-based NSAIDs.

If a number of NSAIDs become unavailable, many consumers may turn to over-the-counter (OTC) aspirin-based* NSAIDs again until an alternative is found. Aspirin-based NSAIDs are known to cause bleeding in the digestive tract, but long-term or high-dose use can lead to a hidden and far more profound problem than intestinal bleeding; it can create a gastro-intestinal (GI) disorder known as intestinal permeability or leaky gut.

CATCH-22
Nutrients from the digestion of food enter the bloodstream primarily through the small intestine. In its healthy state the small intestine ‘screens out’ materials that should not enter the blood, but if the lining of the small intestine becomes damaged, then molecules can enter the bloodstream that should not be there. These ‘alien’ molecules can include inadequately digested nutrients, but also gut and bacterial toxins.

If the immune system is exposed to these ‘invaders’ on a regular basis it may begin to over-react, become umbalanced—and create an underlying allergic or inflammatory condition in the body. Paradoxically, it can be this very problem that contributes to inflammatory conditions. Here is the recipe: chronic pain can lead to chronic use of medications—that can lead to gut permeability—that can cause chronic inflammation. Ouch.

NSAIDs are not alone in being linked to intestinal permeability; the list also includes the chronic use of alcohol, antibiotics, corticosteroids, certain chemotherapeutic drugs, extreme stress, candida overgrowth or unbalanced gut ecology.

A WHOLISTIC APPROACH
As a naturopath I am extremely concerned, not just with helping to alleviate unbearable and chronic pain, but also with discovering what may be causing and exacerbating the condition.

There are a number of safe and very effective non-drug ways to deal with inflammatory pain, some work to help the immediate discomfort, and others can be used long-term to address the underlying cause.

If pain is simply silenced without resolution of its genesis, then the degeneration will continue. Pain-killers do not halt the progression of a disease process, they only relieve the pain…which is the body’s cry for help at a much deeper level.

The problem with an inflammatory condition that is only being addressed at a superficial level, is that the underlying condition continues, attacks the weakest areas first—and is progressive. In other words, if only the pain, but not the ‘pain generating factor’ is being addressed, then the inflammatory problem will continue to manifest in many different, and unremitting ways, and ultimately, surgery may be the only option to bring relief.

NO MAGIC BULLETS
Currently there are no natural ‘magic-bullets’, that have the same power as corticosteroids (or other pharmaceutical wonders) to address the kind of pain associated with debilitating conditions like advanced osteo or rheumatoid arthritis. But, for less-advanced joint and inflammatory conditions that respond to medications like Vioxx™ or Celebrex™, there are extremely effective natural alternatives available from your naturopath and…most importantly, protocols for dealing with the cause of the problem.

*Studies have just emerged that suggest paracetamol/acetaminophen-based medicines may also produce negative GI effects, and long-term or chronic use puts a great deal of strain on the body’s detoxification mechanisms especially the liver and kidneys.

Copyright©2004 Gillian Martlew, ND. May not be reproduced in any form whatsoever or copied or stored in an information retrieval system, or made available on a website without written permission of the author.