The systematic review of 18 studies, published this week in Alimentary Pharmacology & Therapeutics, is contrary to the general belief that people with inflammatory bowel conditions like Crohn’s disease or ulcerative colitis should avoid all nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen.

 The met-analysis of the studies published between 1983 and 2016 did not reveal a consistent association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol and the exacerbation of inflammatory bowel conditions.

But when the analysis was limited to studies with a low risk of bias there was a link found between NSAIDs and the exacerbation of Crohn’s disease but not ulcerative colitis.

The analysis was funded by the American Gastroenterological Association, the National Institute of Diabetes and Digestive and Kidney Disease and three pharmaceutical companies.

Dr Hamed Khalil, of Massachusetts General Hospital and lead author of the study, said researchers were surprised to see that there was little data in the literature to support “our common recommendations to patients with inflammatory bowel disease to avoid all NSAIDs.”

The study was prompted by the general belief that NSAIDS, unlike paracetamol (acetaminophen), were associated with the increased risk of IBD exacerbation.

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