Hi everyone,

Please comment on the following.

- Is there any evidence that ibuprofen is less caustic to the stomach (than
aspirin), or are they both about equal.  I recognize aspirin thins the blood
more, so inherently is worse if you were already near bleeding.  But aside
from that are they both about equal on stomach irritation or is aspirin
worse.

- I also understand that the NSAIDS block prostaglandins as there main
vehicle for pain relief; and the stomach mucosa needs prostaglandins (the
good prostaglandins) to protect its mucosa.  How much of the stomach is
damaged by NSAIDS blocking the prostaglandins by getting into the blood
stream versus direct contact with the stomach.  And does aspirin damage the
stomach more by direct contact than ibuprofen.  I also recognize that the
NSAIDS can get into the blood stream directly through the stomach wall
(unlike most drugs) since they are lipid soluble.   Does this imply that
they can block the "good" prostaglandins in the stomach faster, since they
go through the wall and into the blood and come right back out again (excuse
me if I am getting a little too imaginative here).

- Is buffered aspirin less likely to eat your stomach than non buffered
aspirin or ibuprofen.  I take it reluctantly, but I really don't think it
matters.  It provides a local antacid coating so to speak.  Does this really
help or not, and if so why doesn't everyone take bufferin instead of non
buffered aspirin or other NSAIDS.

I went to a urologist today for a second opinion on my prostate surgery, and
he told me he thought that ibuprofen was better than aspirin (for your
stomach), but could not back it up when I diplomatically tried to query him
on it.  He mumbled something about that is why they invented it, but I
talked to a pharm D afterward and she said it was more on the line that it
thinned the blood less (not because it was less caustic to the stomach).

Please shed some light on this if you can.  I am in severe non stop pain and
discomfort (from a TURP that is not getting better), and I can not take
opiates since they constipate me.  Acetaminophen is no good since it has no
anti-inflammatory properties like the NSAIDs do.  I take PPIs for my stomach
and GERD so I don't want to take too many NSAIDS.  Would I be better of with
the bufferin or the ibuprofen (neither which help my pain - but I have to
take something).  I started 50 mg of amitriptyline last night and it has
already constipated me.  Oh well.  Thanks for your attention.

Pete