Previous Thread
Next Thread
Print Thread
Do topical NSAIDs avoid stomach upset? #281527
09/28/18 11:43 AM
09/28/18 11:43 AM
Joined: Sep 2018
Posts: 22
L
lazlo Offline OP
Registered Visitor
lazlo  Offline OP
Registered Visitor
L

Joined: Sep 2018
Posts: 22
Brief preface: I'm 41yo, have suffered with back pain that doctors had no explanation for over the 25 years, and never heard the term "ankylosing spondylitis" until 10 days ago. And I am *hoping* this is finally a diagnosis....so I have approximately 10,000 questions. That said...

I was prescribed Meloxicam two months back by a doctor who thought I had rheumatoid arthritis. It helped some but caused terrible stomach upset, reflux, etc. so is not a viable option. I've read of others who used topical NSAIDs instead. For those with any experience do these avoid the stomach upset/reflux side effect? And/or have others who had trouble with Meloxicam used alternative NSAIDs that did NOT cause stomach upset/reflux?

Thanks very much!!

Re: Do topical NSAIDs avoid stomach upset? [Re: lazlo] #281529
09/28/18 12:09 PM
09/28/18 12:09 PM
Joined: Jun 2016
Posts: 435
W
Winston Offline
Registered Visitor
Winston  Offline
Registered Visitor
W

Joined: Jun 2016
Posts: 435
Try Celebrex. Of all the NSAIDs, it's easiest on the gut. As for the topicals, they are less harsh on the gut, but they're not typically prescribed for back pain. They work well on smaller joints that are nearer the body surface, e.g., the knees. Were you taking a proton pump inhibitor, e.g., Prilosec, with the Meloxicam? PPIs are typically prescribed with NSAIDs to protect the gut if you're going to be taking the NSAID continuously.

Have you seen a rheumatologist? You need one.

Re: Do topical NSAIDs avoid stomach upset? [Re: Winston] #281530
09/28/18 01:28 PM
09/28/18 01:28 PM
Joined: Sep 2018
Posts: 22
L
lazlo Offline OP
Registered Visitor
lazlo  Offline OP
Registered Visitor
L

Joined: Sep 2018
Posts: 22
Thanks so much, very helpful info! I have not seen a rheumatologist yet, working on finding one right now. I'm incredibly frustrated because I complained enough two years ago to finally get my doctor to order an MRI and when it came back he was like, "Yeah, there's nothing here, probably just moderate arthritis, nothing you can do." No mention of AS, no ideas, nothing. Anyway, I'm trying to get the digital files from that MRI, thinking that bringing them to the rheumatologist would be wise? I hope? I'm 80% so excited to have found out this information about AS and 20% so frustrated that I have been complaining about TEXTBOOK symptoms of this for so many years and not one doctor I spoke to ever even suggested it. frown

Re: Do topical NSAIDs avoid stomach upset? [Re: lazlo] #281531
09/28/18 02:21 PM
09/28/18 02:21 PM
Joined: Jun 2016
Posts: 435
W
Winston Offline
Registered Visitor
Winston  Offline
Registered Visitor
W

Joined: Jun 2016
Posts: 435
Yes, unfortunately, it is still the case that many general practitioners and orthopedists don't think of AS when a patient presents with back pain. (Orthopedists are the worst, IMHO). Mention it to them and you get a blank stare followed by a brief moment of panic and a visible searching of their mental files for that chapter on inflammatory arthritis in their medical school textbook.

The MRI images -- note, not just the radiologist's report -- may be helpful to a rheumatologist when evaluating your case. You also likely need an xray of your SI joints, possibly a new MRI of your SI joints, and bloodwork. Did the doctor who prescribed the meloxicam for suspected rheumatoid arthritis (you didn't get a rheumatology referral with that?) order an autoimmune panel to confirm that diagnosis? If not, you need an autoimmune panel (to rule out RA and other things), the HLA-B27 genetic test, a CBC, a metabolic panel, a CRP, and an ESR. That's the standard workup for suspected AS.

Re: Do topical NSAIDs avoid stomach upset? [Re: Winston] #281536
09/28/18 05:21 PM
09/28/18 05:21 PM
Joined: Sep 2018
Posts: 22
L
lazlo Offline OP
Registered Visitor
lazlo  Offline OP
Registered Visitor
L

Joined: Sep 2018
Posts: 22

This is all incredibly helpful. I'm hoping to see a rheumatologist (one recommended from this site!) in the next week or two. I'm 95% sure the meloxicam prescriber did not order an autoimmune panel. And sorry for a dumb question but what is RA?

Re: Do topical NSAIDs avoid stomach upset? [Re: lazlo] #281552
09/30/18 01:52 AM
09/30/18 01:52 AM
Joined: Sep 2018
Posts: 22
L
lazlo Offline OP
Registered Visitor
lazlo  Offline OP
Registered Visitor
L

Joined: Sep 2018
Posts: 22

Never mind, figured out RA. Lol. Getting used to the terminology, just take me a little time. smile

Re: Do topical NSAIDs avoid stomach upset? [Re: lazlo] #281676
10/08/18 05:12 PM
10/08/18 05:12 PM
Joined: Jun 2012
Posts: 560
Los Angeles, CA
RAHMBA Offline
Registered Visitor
RAHMBA  Offline
Registered Visitor

Joined: Jun 2012
Posts: 560
Los Angeles, CA
There are some wonderful top tier spondylitis experts on the community webpage. These are full lenghth presentations on what AS is, how to treat it. each also has an extended question and answer period by people living with AS.

There are seminars by Dr. Caplan, Dr. Reveille, Dr. Weisman, Dr. Gensler, Dr. Hallegua.

There are also full length presentations on AS by other content experts in physical therapy, psychology, opthalmology.

https://www.spondylitis.org/Seminars-and-Webinars

The next live seminar is in Chicago this month.


AS, U C, Iritis, migraines. HLA-B27neg. Yoga (instructor) & spin. No meds at this time. Dx 1989. SAA member/donor since 1993. All my posts are personal opinion/feelings and do not represent the SAA. Help find a cure & support others by donating to the SAA.

Moderated by  ElinAslanyan, RyanMiyamoto 

Powered by UBB.threads™ PHP Forum Software 7.6.2