Ibuprofen and NSAIDs of other brands are used frequently by athletes around the world. Commonly referred to as Vitamin I, many athletes believe ibuprofen improves performance by extending the duration of pain free training or competition, despite evidence to the contrary.
A recent flurry of studies on male athletes indicates exercise induces a type of gut injury commonly seen in patients post surgery called splanchnic hypoperfusion or inadequate blood flow to the gut, kidney and liver. The abdominal distress common with intense training or competition, is really a state of reduced blood flow to the gut. The reduction in blood flow makes sense given the biological predilection to funnel energy away from digestion and metabolism during periods of fight or flight, even those that are self-induced.
GI hypoperfusion causes all sorts of mostly minor injuries, including general GI dysfunction, increased inflammation, increased permeability of endotoxins, but also, can cause more severe ischemic events – the complete cessation of blood flow to a particular abdominal region. Repeated periods of hypoperfusion may cause more damage.
To counter the pain associated with GI hypoperfusion and training in general, athletes often self-dose with ibuprofen. Research indicates that ibuprofen increases the GI damage and does not improve performance. In fact, ibuprofen users often experience more pain, abdominal and otherwise, and perform more poorly.
Consistently, the research on ibuprofen use by athletes is conducted with male athletes. What about about female athletes? More specifically, how does regular, though cyclical, often high dose ibuprofen use to relieve menstrual pain, affect GI function and athletic performance in female athletes? Are female athletes more susceptible to splanchnic hypoperfusion and the ensuing endotoxemia? Does the use of ibuprofen worsen the abdominal injury or perhaps even worsen the menstrual pain as time passes? Research on pain tolerance suggests that ibuprofen does not work at all for many women, despite the fact that women are the largest users of ibuprofen for a range of predominantly female conditions. Similarly, research on analgesic response across the menstrual cycle demonstrates clear cycle-related changes in analgesic effectiveness. Given the high usage rates of ibuprofen in women, especially athletic women, it would seem relevant to investigate gender differences in ibuprofen effectiveness and gut damage.
If you have research on these topics, please send them to us. We’d like to know and our readers would like to know.
Photo: by Dirk Hansen (Flickr) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons