There are a few schools of thought on this issue. According to the literature, about a third of IBD patients are sensitive to NSAIDs and they will precipitate an IBD flare. The concern here is pouchitis. There is a definite link between the use of NSAIDs immediately post op and chronic pouchitis. There also is a link between NSAID use and acute pouchitis.
So, that leads some doctors to say- no NSAIDs ever. Of course, this makes perfect sense if you have known IBD flares related to NSAID use (or other reasons not to use them- at one time I was told to avoid them due to liver inflammation that was presumed to be caused by them. However, this turned out to not be true in my case.)
Then there are the doctors who are willing to allow you to try NSAIDs on a trial basis, with the understanding that you will have to discontinue if you develop pouchitis or other GI symptoms (side effects are reversable). For those suffering with arthritis or other musculoskeletal disorders, NSAIDs are a mainstay.
My personal experience is that I was able to tolerate Motrin in high doses for years. Then I did develop pouchitis symptoms and discontinued it. I now take Mobic (meloxicam), which is less likely to cause GI side effects. For me, the risk is well worth the benefit of being to be functional with my enteropathic arthritis.
There are few alternatives to NSAIDs for chronic inflammation. Steroids work well, but are only for short term use (as we all know). If you have IBD related arthritis that is peripheral only (no spinal involvement), Azulfidine (sulfasalazine) may work for you. However, if you are allergic to sulfa, that one is not good for you either.
Jan
Take a deep breath and relax; this too will pass.
