Aggravation of exercise-induced intestinal injury by ibuprofen in athletes

Journal article


Van Wijck, Kim, Lenaerts, Kaatje, van Bijnen, Annemarie A., Boonen, Bas, Van Loon, Luc J.C., Dejong, Cornelis H. C. and Buurman, Wim A.. (2012). Aggravation of exercise-induced intestinal injury by ibuprofen in athletes. Medicine and Science in Sports and Exercise. 44(12), pp. 2257 - 2262. https://doi.org/10.1249/MSS.0b013e318265dd3d
AuthorsVan Wijck, Kim, Lenaerts, Kaatje, van Bijnen, Annemarie A., Boonen, Bas, Van Loon, Luc J.C., Dejong, Cornelis H. C. and Buurman, Wim A.
Abstract

VAN WIJCK, K., K. LENAERTS, A. A. VAN BIJNEN, B. BOONEN, L. J. C. VAN LOON, C. H. C. DEJONG, and W. A. BUURMAN. Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes. Med. Sci. Sports Exerc., Vol. 44, No. 12, pp. 2257–2262, 2012. Introduction: Nonsteroidal anti-inflammatory drugs 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 before exercise on GI integrity and barrier function in healthy individuals. Methods: Nine healthy, trained men were studied on four different occasions: 1) 400 mg ibuprofen twice before cycling, 2) cycling without ibuprofen, 3) 400 mg ibuprofen twice at rest, and 4) rest without ibuprofen intake. To assess small intestinal injury, plasma intestinal fatty acid binding protein (I-FABP) levels were determined, whereas urinary excretion of orally ingested multisugar 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 T 137, 474 T 74, 507 T 103, and 352 T 44 pgImLj1 , respectively, P G 0.002). In line, small intestinal permeability increased, especially after cycling with ibuprofen (0–2 h urinary lactulose/rhamnose ratio, 0.08 (0.04–0.56) compared with 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 G 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 nonsteroidal anti-inflammatory drugs consumption by athletes is not harmless and should be discouraged. Key Words: NSAID, EXERCISE, GASTROINTESTINAL DAMAGE, PERMEABILITY

Year2012
JournalMedicine and Science in Sports and Exercise
Journal citation44 (12), pp. 2257 - 2262
PublisherLippincott Williams & Wilkins
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0b013e318265dd3d
Scopus EID2-s2.0-84870063060
Page range2257 - 2262
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited States
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