Pain Relief Today, GI Bleed Tomorrow?

When Over-the-Counter Turns Dangerous: A Cautionary Tale from the ER

Here is the response to the video that went viral on my socials at DRJPARENTE regarding the patient who came in hypotensive, tachycardic, and dropped 4g off her Hemoglobin. Thanks for engaging with my video and don't forget to subscribe for more interesting medical cases.

As an emergency medicine physician, I’ve seen countless cases that could’ve been avoided with just a little more awareness. One recent patient reminded me of the hidden dangers that even common medications can pose, particularly NSAIDs.

She came into the ER hypotensive, tachycardic, pale, and weak. The kind of presentation that instantly sets off alarms.

As we worked quickly to stabilize her, the pieces of the puzzle started coming together. She had recently fractured her leg and had been managing the pain at home with over-the-counter ibuprofen. No prescription narcotics, no heavy medications—just a steady stream of NSAIDs to keep the pain at bay.

But what she didn’t realize, and what many people don’t, is that NSAIDs (non-steroidal anti-inflammatory drugs like ibuprofen, naproxen, and others) can be far from harmless, especially when taken in higher doses or over extended periods. In her case, the chronic use of these medications had led to a gastrointestinal (GI) bleed. The blood loss was significant enough to drop her blood pressure and leave her severely anemic and symptomatic.

We were able to treat her and get her stabilized, but the case serves as an important reminder:

🩺 NSAIDs aren’t risk-free just because you can buy them without a prescription.🩸 They can erode the stomach lining, increase the risk of ulcers, and lead to GI bleeds—especially in older adults or those taking them regularly.💊 Combining NSAIDs with other meds like blood thinners or steroids increases the risk even more.🥼 If you're dealing with ongoing pain—especially after an injury—talk to your doctor before making NSAIDs part of your daily routine.

Too often, we assume that if it’s sold in a pharmacy aisle, it must be safe. But the truth is, even over-the-counter meds can have serious side effects if not used properly.

So if you’ve been popping ibuprofen or naproxen more days than not—or if you have underlying medical issues like ulcers, kidney disease, or take medications like aspirin or anticoagulants—please check in with your healthcare provider.

Your stomach (and possibly your future self in the ER) will thank you.

Stay safe, stay smart—and don’t be afraid to ask questions about even the most “harmless” meds. The ER is always here if you need us, but we’d much rather help you stay out of it.