Should Ibuprofen be withheld for patients suffering possible Crohns, colitis and IBS flare ups?

Ibuprofen can be withheld in any patient that tells you they have a condition wherein they should not receive NSAID. However, it is reasonable to administer Ibuprofen to a patient with Inflammatory Bowel Disease (Chrohns, Ulcerative Colitis) or Irritable Bowel Syndrome (IBS), who does not tell you they should abstain from NSAIDs. It is not a Contraindication per the Analgesia Medical Directive. There is some published information that NSAID use may cause a flares in these conditions. However, a recent meta-analysis shows the data is conflicting and the answer is not clear. Therefore, a single dose of Ibuprofen is unlikely to cause a flare and should not be routinely withheld.

Kefalakes, H., Stylianides, T.J., Amanakis, G. et al. Exacerbation of inflammatory bowel diseases associated with the use of nonsteroidal anti-inflammatory drugs: myth or reality?. Eur J Clin Pharmacol 65, 963€“970 (2009). https://doi-org.proxy1.lib.uwo.ca/10.1007/s00228-009-0719-3

Analgesia,Pain/Sedation/Nausea

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