Nabumetone (NSAID) for my back...should I be worried?

NSAIDs will make you more prone to pouchitis, but they don’t guarantee it. You might improve the risk profile by adding a strong probiotic like VSL #3.

I also have arthritis and I take nabumetone when I have flares. However, I do limit myself to two week courses, as I have had pouchitis flares from NSAID use. But, I have to function too. Hard to find that balance. The good news is that if NSAIDs bother your pouch, it is reversible.

Jan

NSAIDS give me the worst belly ache and I was told by my doctor not to take them.  My Rheumy put me on Sulfasalzine for my arthritis. 

The first year or two i had my j-pouch I'd take aspirin and ibuprofen and had three bouts of pouchitis.  The last ten years I've taken neither and have not had one bout of pouchitis.  However - I do take meloxicam fairly frequently for weight-lifting related injuries and tendonitis and  I've never had an issue.  Meloxicam is an NSAID as well so I don't know if it's because it doesn't cause pouchitis or simply because (like Jan) I limit how much and how long I take it.

Thanks for the replies everybody. I have been on the Nabumetone for 3 days, 750 twice a day and I definitely feel like I have had to go to the bathroom more often, but I have not felt horrible. I am going to take it a bit longer and hopefully, things are good with the pouch. It would be nice to not be in pain as far as my back goes.

Watch for increased frequency, a sense of urgency, lots of stomach gurgling. Those were my pouchitis-induced symptoms when I took NSAIDS. My final symptom was bleeding. It felt like U.C. all over again.

Rose- how long did it take to get to the point where you were bleeding? It has been 5 days and mostly just increased frequency. I sure hope it doesn't get to the point of bleeding again. I have had enough of that for a lifetime.

Hi Sam,

As I recall, I had a very gurgly gut area for almost a week. At the end of that week on the weekend, I had much increased frequency and urgency. I remember being out shopping and thinking that I needed too get home to use the restroom. I thought it very strange because I hadn't had the urgency or frequency since the j-pouch surgery. The frequency/urgency/gurgling continued into the next week and I also started having a dull pain in my tailbone area and had no energy. By Friday of the end of that second week, it started bleeding. It was at night and it was enough that I headed for the emergency room. I was given Cipro & Flagyl for 14 days and never had a problem after they figured it was the Excedrin Migraine and Ibuprofen I had been taking for at least a couple of months that caused the pouchitis. So I'd say that it took about two weeks for all of those symptoms to gradually appear with the bleeding being the final blow at the end of the two weeks.

Rose

Thanks for the info. I don't think my back doctor knows much about the pouch so I will check in with him on Tuesday to discuss whether I should stop taking the Nabumetone. As Jan mentioned before, it is a hard balancing act trying to deal with the arthritis while not aggravating the pouch. 

You might check with your GI doc as well to see if he/she has any tricks up his sleeve to get around the use of Nabumetone. I hope your pouch isn't reacting to it. Good luck with this!!

The back doctor told me to stop the Nabumetone since it was disturbing my stomach and causing a large increase in bowel movements but then suggested Celebrex because it is easier on the stomach. The only problem is that I cannot take Sulfa drugs since I have had a bad experience in the past with my UC. It is hard to trust this doctor since he seemed to completely overlook my past history. They are now saying I can consider injections after the physical therapy. It is all getting frustrating since I have tried therapy in the past with little to no improvement. I ended up paying 700 dollars out of pocket for the MRI and office visit last week with no real help provided by the doctor. 

The only thing that has worked without hurting my stomach has been Prednisone. Does anybody have any other suggestions for medication or supplements that might help kill the inflammation without the stomach issues? I am going to start the physical therapy and maybe it works this time. I am also going to try to lose some weight and hopefully, that helps with the arthritis and degenerative disc issues.

Thanks again everyone for the support.

Sam

Prednisone could help, but I would not mess with anything other than a fast taper. For me, it is 40mg/day x 3 days, 30mg/day x 3 days, 20mg/day x 3 days, 10mg/day x 3 days, then stop. That usually helps get me past a severe inflammatory arthritis flare. But, not always. Right now I am taking a couple of weeks of nabumetone (Relafen) for neck pain with radiculopathy (due to spinal stenosis) after the prednisone taper was not very effective. My rheumy refuses to order Celebrex for me due to the cardiac risk profile, but all NSAIDs are associated with an increased risk. I was on meloxicam (Mobic) at one point (for about a year I think), which is similar to it without the sulfa. It is a very early COX-2 selective NSAID. Not as gut sparing as Celebrex, but better than ibuprofen. Relafen just works better for me.

I never had a bleeding specific with NSAIDs, just gut symptoms, pouchitis, and liver inflammation.

Jan

Thanks, Jan. I was on the Nabumetone for one week and I was experiencing the gut symptoms, bloating and increased number of bowel movements, so I felt like I was on my way to pouchitis.  I will inquire about the Mobic. 

Thanks again!