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How is it that one of the main drugs for one AI (lupus) causes flares in another (UC)?

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Ulcerative Colitis
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Posted 12/24/2013 6:05 PM (GMT 0)
I'm talking about non-steroid anti-inflammatories.

Both are auto-immune disorders. The symptoms for one get better using NSAIDs; for the other, NSAIDs can cause a flare?

go figure

Also, side note. Do people really refer to "NSAID"s as "en-sed"s?
Posted 12/24/2013 6:31 PM (GMT 0)
Janey, I'm sorry you're afflicted with lupus as well as UC. But the mechanisms of NSAID damage to the gastrointestinal tract is well established. Many people without IBD experience terrible damage from extended use of NSAIDs. I don't know if you're using the episodically for pain management but there are other options your rheumatologist should be able to discuss with you. My GI told me last week that if I do choose to use NSAIDs for anything I should also use a ppi. That made sense to me (although I still do not plan to use any NSAIDs). The last time I used some was 18 months ago when I took naproxen twice over 24 hours and ended up with horrible upper GI pain and several days of diarrhea.
Posted 12/24/2013 8:12 PM (GMT 0)
I'm guessing that the NSAIDs decrease the inflammation related to Lupus while making the GI tract more susceptible to bleeding (bad for UC).

Sorry you are stuck in this big trap of diseases :(.
Posted 12/24/2013 8:47 PM (GMT 0)
I say and have heard it only as "en-seds".

The ones you're taking are systemic, going through the stomach/liver/intestines. For some NSAIDs, I would assume...they can definitely cause havoc on digestive disease (depending on how the body reacts and how sensitive it is already) compared to others.

What are you taking at this point?

I hope you find a balance with meds to get you relief on both fronts.

q
Posted 12/24/2013 8:48 PM (GMT 0)
Thanks, all of you, for your condolences. Luckily, it's a "low positive" and I'm not actually medicated yet. My main symptom at the moment is fatigue and you know what the recommendations are for that? Get more rest. Ha, as if I can.

Ho ho ho, and to all a good night smurf <- that's me in my santa hat today, but only if you're color blind LOL
Posted 12/24/2013 9:02 PM (GMT 0)
Yes, "en-saids" (the correct way to say it) can cause gastric bleeding even in people with normal GI tracts. They're very irritating to the mucus membrane lining the tract and can cause irritation, especially if taken on an empty stomach. Some people with IBD can't tolerate them at all, others they don't seem to bother.
Posted 12/24/2013 9:05 PM (GMT 0)
such as "en-sayds"?
q
Posted 12/26/2013 11:47 PM (GMT 0)
Hmm, I was just sitting here wondering. Where does the D come from?
Posted 12/27/2013 1:07 AM (GMT 0)
drugs.
Posted 12/27/2013 1:17 AM (GMT 0)
*facepalm*
Posted 12/27/2013 8:14 AM (GMT 0)
Janey47 just a quick question for you in regards to having uc and lupus

What did your ana result come back as and do you also suffer low levels of vitamin d?

Why I am asking is my ana test came back positive and my doctor asked if I had a family history of lupus but on several occasions my vitamin d level has been low also and is getting worse not better so I am on 4000 a day for at least 3 months..
Posted 12/27/2013 1:23 PM (GMT 0)
I gave details a while ago on why NSAIDs would make GI system susceptible to ulcers. It acts through COX and LOX enzyme system in turn affecting Prostaglandin G2. (If you would like to read up that paper, I will dig it up and send it to you.) I don't know much about lupus and how NSAIDs work in Lupus, but if NSAIDs help you with Lupus then give a shot to Nabumetone 750mg (Relafen). It should work without GI disturbances. I have taken this as much as 5X a week, without trouble. I avoid using it as much as I can though, because that is the only thing that works with my migraine.

Vit D levels are also important. I personally noticed, as my Vit D increased, somehow my GI issues got under control (but I do not have 'proof' that its Vit D only, because my GI was suspicious my drugs were not working and she changed the drugs too). Optimum level of Vit D, esp in winter certainly won't harm.
Posted 12/27/2013 6:30 PM (GMT 0)
ANA 1:80 and also positive for anti-dsDNA antibodies, so low positive. I have a couple of symptoms but not severely. Photosensitivity, fatigue, Raynaud's, and some joint soreness and swelling but I never thought much of any of it until recently.

My c-reactive protein was 176 -- my GI said with those levels he would expect me to be in a major flare but since I'm not it indicated inflammation elsewhere

ESR is normal

Ant-Sm normal

I'm slightly anemic, go figure, and it's not from blood loss because I just haven't been bleeding that much, but maybe that explains the fatigue that I've been blaming on lupus

My Vitamin D levels get tested regularly because I've been borderline low for a long time but I'm on 2500 mg a day now and they're fine

I feel like I have a small amount of a thousand AI disorders. "Moderate" UC. "Borderline" lupus. Hashimoto's thyroiditis controlled by medication. One of the genetic mutations for celiac disease (and a niece who has celiac and also I seem to react to gluten).

It's just one thing after another.
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