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Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes.
MedLine Citation:
PMID:  22776871     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used by athletes to prevent anticipated exercise-induced pain, thereby putatively improving physical performance. However, these drugs may have potentially hazardous effects on the gastrointestinal (GI) mucosa during strenuous physical exercise. The aim of the current study was to determine the effect of oral ibuprofen administration prior to exercise on GI integrity and barrier function in healthy individuals. METHODS: Nine healthy, trained men were studied on 4 different occasions: (1) 400 mg ibuprofen twice prior to cycling, (2) cycling without ibuprofen, (3) 400 mg ibuprofen twice at rest, (4) rest without ibuprofen intake. To assess small intestinal injury, plasma intestinal fatty acid binding protein (I-FABP) levels were determined, while urinary excretion of orally ingested multi-sugar test probes was measured using liquid chromatography and mass spectrometry to assess GI permeability. RESULTS: Both ibuprofen consumption and cycling resulted in increased I-FABP levels, reflecting small intestinal injury. Levels were higher after cycling with ibuprofen than after cycling without ibuprofen, rest with ibuprofen, or rest without ibuprofen (peak I-FABP 875±137, 474±74, 507±103, and 352±44 pg/mL, respectively, P<0.002). In line, small intestinal permeability increased, especially after cycling with ibuprofen (0-2h urinary lactulose/rhamnose (L/R) ratio 0.08(0.04-0.56) compared to 0.04(0.00-0.20), 0.05(0.01-0.07), and 0.01(0.01-0.03), respectively), reflecting loss of gut barrier integrity. Interestingly, the extent of intestinal injury and barrier dysfunction correlated significantly (RS=0.56, P<0.001). CONCLUSION: This is the first study to reveal that ibuprofen aggravates exercise-induced small intestinal injury and induces gut barrier dysfunction in healthy individuals. We conclude that NSAID consumption by athletes is not harmless and should be discouraged.
Kim van Wijck; Kaatje Lenaerts; Annemarie A van Bijnen; Bas Boonen; Luc Jc van Loon; Cornelis Hc Dejong; Wim A Buurman
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-6
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  -     ISSN:  1530-0315     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Top Institute Food and Nutrition, Wageningen, the Netherlands 2Department of Surgery, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands 3Department of Human Movement Sciences, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands.
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