Medical experts are calling the problem a "silent epidemic" that takes almost as many lives as AIDS. According to the National Center for Health Statistics, AIDS killed 16,685 people in the U.S. in 1997.
Both prescription and over-the-counter forms of these medicines, known as nonsteroidal anti-inflammatory drugs (NSAIDs), can eat away at the stomach's mucous lining, creating a hole in the stomach or intestinal wall. Often people ignore the symptoms, thinking it's harmless heartburn, but the ulcers can worsen, causing chronic pain and internal bleeding. The complications from these ulcers can lead to death.
NSAIDs include aspirin, ibuprofen, and the active ingredients in Aleve, Naprox, Voltaren and Indocin.
"This is, in many ways, a silent epidemic because gastrointestinal complications are not preceded by any warning signs in many individuals," said Dr. M. Michael Wolfe of the Boston University School of Medicine, a lead researcher in the study.
If the deaths that occur from ulcer-related complications associated with painkillers were given their own category, Wolfe and his colleagues report in the Journal that the toxic effects of NSAID drugs "would constitute the 15th most common cause of death in the United States."
Older people who suffer from rheumatoid and osteoarthritis are at the greatest risk because they regularly take prescription NSAIDs for their discomfort.
There are painkillers available that do not cause the stomach problems associated with NSAIDs, such as acetamenophen or the recently approved COX-2 inhibitors, or "super aspirins," as they are known. COX-2 inhibitors are designed to fight the pain, but protect the stomach.
However, more research is needed to determine whether they are indeed safer than other painkillers.