Common concerns about all-purpose pain relievers

For all-purpose pain relief, much of the world turns to ibuprofen, a very effective nonsteroidal anti-inflammatory drug (NSAID). Another NSAID, naproxen is also available without a prescription. As some patients discover, however, heavy use of NSAIDs can offset their value as pain fighters.

• The risk of developing stomach problems is relatively small, especially if you take them only occasionally.
•  Heartburn and upset stomach occur in about 10 to 20 percent of people who take NSAIDs.
• Stomach bleeding and perforation (literally, a hole in the stomach) have been linked to NSAIDs -- affecting about one to three percent of people who use the drugs regularly.
• The risk is greatest if you are elderly, take high doses of NSAIDs, take more than one NSAID at a time, have a history of GI problems, or take blood-thinning drugs.

NSAIDs such as ibuprofren and naproxen do appear to interfere with aspirin's ability to prevent blood clots. If you take a daily aspirin for heart protection, ask your doctor whether it's okay to use ibuprofen for pain. The US Food and Drug Administration says that it's safe to take 400 milligrams of ibuprofen at least 30 minutes before or eight hours after taking an aspirin.

While it's a good idea to discuss which pain relievers you use with your family doctor, most physicians agree that NSAIDs are generally safe for occasional use.