Ibuprofen and endurance sports read this

[Payton MacDonald]

Looks like there could be some evidence that Vitamin I is indeed bad for your GI tract.  Thought you all might find this interesting.  I guess it's back to good old beer to relieve the pain . . .


Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes.
Authors Van Wijck K, Lenaerts K, Van Bijnen AA, Boonen B, Van Loon LJ, Dejong CH, Buurman WA.
Affiliation Top Institute Food and Nutrition, Wageningen, The Netherlands. k.v.wijck@gmail.com
Journal Med Sci Sports Exerc. 2012 Dec;44(12):2257-62. doi: 10.1249/MSS.0b013e318265dd3d. PMID 22776871

Abstract

INTRODUCTION: Nonsteroidal anti-inflammatory drugs are commonly used by athletes to prevent anticipated exercise-induced pain, thereby putatively improving physical performance. However, these drugs may have potentially hazardous effects on the gastrointestinal (GI) mucosa during strenuous physical exercise. The aim of the current study was to determine the effect of oral ibuprofen administration before exercise on GI integrity and barrier function in healthy individuals.

METHODS: Nine healthy, trained men were studied on four different occasions: 1) 400 mg ibuprofen twice before cycling, 2) cycling without ibuprofen, 3) 400 mg ibuprofen twice at rest, and 4) rest without ibuprofen intake. To assess small intestinal injury, plasma intestinal fatty acid binding protein (I-FABP) levels were determined, whereas urinary excretion of orally ingested multisugar test probes was measured using liquid chromatography and mass spectrometry to assess GI permeability.

RESULTS: Both ibuprofen consumption and cycling resulted in increased I-FABP levels, reflecting small intestinal injury. Levels were higher after cycling with ibuprofen than after cycling without ibuprofen, rest with ibuprofen, or rest without ibuprofen (peak I-FABP, 875 ± 137, 474 ± 74, 507 ± 103, and 352 ± 44 pg·mL, respectively, P < 0.002). In line, small intestinal permeability increased, especially after cycling with ibuprofen (0-2 h urinary lactulose/rhamnose ratio, 0.08 (0.04-0.56) compared with 0.04 (0.00-0.20), 0.05 (0.01-0.07), and 0.01 (0.01-0.03), respectively), reflecting loss of gut barrier integrity. Interestingly, the extent of intestinal injury and barrier dysfunction correlated significantly (RS = 0.56, P < 0.001).
 
CONCLUSION: This is the first study to reveal that ibuprofen aggravates exercise-induced small intestinal injury and induces gut barrier dysfunction in healthy individuals.
We conclude that nonsteroidal anti-inflammatory drugs consumption by athletes is not harmless and should be discouraged.

[fotooutdoors]

I have avoided ibuprofen for a while based on the fact that it likely slows recovery (I don't have links to the studies atm, but a quick search on google scholar should help).  That said, taking anti-inflammatory drugs can have positive effects, especially if you need to continue to exercise instead of resting to heal your muscles/joints (which is what most ultra racing entails).

Thanks for the article link; good information to ponder through my training this year.

[wahday]

Ibuprofen is indeed very rough on your stomach! They also know that taking it prior to exercise has no notable improvement on inflammation or performance (I guess some think that if they feel less pain they can go further). I avoid the stuff unless I absolutely need it. It's also very hard on your liver. But for extreme pain or an injury, it's great to have on hand.

Thanks for posting this - good info for people to be aware of!

[Veetack]

I prefer naproxen (Aleve) as my NSAID of choice. I also take it at night, or when I get to camp. If you can find the PM version, which contains dyphenhydramine, you get the added bonus of being able to fall and stay asleeop much easier. I have pretty bad GERD, which many NSAIDS aggrivate, so I've never once thought to take them before any sort of physical exercise. I also try to keep to the minimum dose that is enough to get the job done. For me, that's 600 mg of ibuprofen vs. 440 mg of Naproxen. Not to mention, it lasts longer.

[intheways]

It's also very hard on your liver.

.

I don't want to be a know-it-all, but that's not really true.  Acetaminophen is hard on the liver.  Ibuprofen is relatively non-toxic to the liver, but it can be harder on intestines (as stated above) and kidneys.

[sub-xero]

I cannot warn enough from using painkillers during endurance sports. I've written something about it here:
About Painkillers