Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

GLP-1 receptor agonists (GLP-1 RAs), including semaglutide widely used to improve diabetes control and promote weight loss, may also reduce the risk of colorectal cancer, according to a new study.

The study found that the effect was particularly notable among people with inflammatory bowel disease (IBD), as well as those with both IBD and type 2 diabetes. Both conditions are associated with a higher risk of colorectal cancer due to chronic inflammation and metabolic changes that may promote tumor development.

"GLP-1 RA use was associated with a significantly reduced incidence of colorectal cancer in all patients with IBD, as well as the subpopulation with both IBD and type 2 diabetes," said lead author Sarina Ailawadi of Case Western Reserve University, US.

"Given the elevated colorectal cancer risk in IBD, these findings suggest a potential protective effect of GLP-1 RA use in this high-risk population. Prospective studies will be important to further analyze and confirm this potential benefit," she added.

The findings will be presented at the 2026 American Society of Clinical Oncology (ASCO) Breakthrough meeting, scheduled for June 25–27 in Singapore.

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How Was The Study Conducted?

This retrospective cohort study analyzed data from 69,221 people in the US, including GLP-1 RA users and non-users.

Researchers also identified 209,649 people with both IBD and type 2 diabetes, including 38,567 who had taken a GLP-1 RA.

After matching users and non-users for various characteristics, data from 37,740 patients were analyzed. The GLP-1 RA group included people taking semaglutide, dulaglutide, tirzepatide, exenatide, liraglutide, or lixisenatide.

The researchers compared the five-year incidence of colorectal cancer between GLP-1 RA users and non-users.

Among people with IBD, the five-year incidence of colorectal cancer was 0.2% in GLP-1 RA users compared with 0.42% in non-users. The odds ratio was 0.49, indicating a 51% lower likelihood of developing colorectal cancer among GLP-1 RA users.

Among patients with both IBD and type 2 diabetes, the five-year incidence of colorectal cancer was 0.31% in GLP-1 RA users and 0.57% in non-users. The odds ratio was 0.54, suggesting a 46% lower likelihood of developing colorectal cancer.

The researchers noted that prospective studies are needed to confirm the potential protective effect of GLP-1 RAs on colorectal cancer risk.

Do IBD and Type 2 Diabetes Increase Colorectal Cancer Risk?

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Inflammatory bowel disease is associated with a higher risk of colorectal cancer, likely because of chronic inflammation in the intestines. People with IBD are estimated to be six times more likely to develop colorectal cancer than those without the condition.

Type 2 diabetes, the most common form of diabetes, also increases colorectal cancer risk and is becoming more common among people with IBD. Scientists believe that individuals with both conditions may face an especially high risk because of the combined effects of chronic inflammation and metabolic dysfunction.

What Are GLP-1 Receptor Agonists?

GLP-1 receptor agonists are a class of drugs that help lower blood sugar levels and promote weight loss. Originally developed to treat type 2 diabetes, many are now widely used for weight management.

These medications mimic the action of the GLP-1 hormone by stimulating insulin release, slowing digestion, and increasing feelings of fullness.

Beyond blood sugar control and weight loss, GLP-1 RAs have been linked to several health benefits, including lower blood pressure and reduced cardiovascular risk. Previous studies have also suggested that they may lower the risk of colorectal cancer and other obesity-related cancers.

However, their specific impact on colorectal cancer risk among people with IBD has remained unclear until now.

Pop singer Madonna has opened up about knee damage caused by years of dancing in high heels.

The 67-year-old superstar said running and Ashtanga yoga also added stress to her joints, leaving her with “no cartilage” in her knee, according to Interview Magazine.

“I have a bad knee now. I have no cartilage in it, thanks to dancing for so long in high heels and running on pavement and doing Ashtanga yoga,” Madonna told the magazine.

“Up until a year ago, I was jumping on trampolines and doing dance cardio and doing a lot of what a doctor would call loading on my joints. Can’t do that anymore,” she added.

Madonna said she still works out regularly while listening to her new album Confessions II, but has had to modify her fitness routine to accommodate the injury.

The Queen of Pop said she now focuses on “Peloton bikes and the Versa Climber and high-intensity circuit training. I ride my bike outside a lot. I dance.”

Madonna has previously been open about her knee injury and its impact on her career. In October 2019, she postponed a scheduled Madame X show in Brooklyn, New York.

“It's Hard for Madame to admit that she is also a human being made of flesh and blood and she must rest for the next 3 days to insure full recovery for her knee,” she wrote on Instagram.

“I am not a quitter. This hurts me more than you can imagine. It's time to take those heels and fishnets off for a few days!”

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Can High Heels Affect Knee Health?

Knee osteoarthritis (OA), a leading cause of disability, is more prevalent in women than men. Wearing high-heeled shoes has been implicated as a potential contributing factor to the higher lifetime risk of osteoarthritis in women.

Several studies have examined the relationship between high heels and knee health. Motion analysis studies have shown changes in knee alignment while walking in heels, changes that researchers have suggested may resemble patterns seen in ageing and knee osteoarthritis progression.

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A 2025 study published in The Knee by researchers from the Singapore Institute of Technology found that wearing 8-cm high-heeled shoes significantly reduced the lateral joint space width of the knee in healthy young women during standing, suggesting increased lateral knee joint stress.

The findings suggest that high heels may specifically affect the lateral compartment of the knee, potentially contributing to increased joint stress during standing.

Wearing heels for long periods can increase the load on the knees. They alter posture and walking patterns, placing additional pressure on the knee joint. Over time, this may strain the ligaments and muscles surrounding the knee, leading to pain, stiffness, and long-term damage.

In 2025, the Nicki Minaj Challenge, inspired by the rapper's 2013 song High School, gained traction on social media. The challenge, which involved balancing in high heels, reportedly resulted in injuries including fractures and, in some cases, deaths.

Most people pay little attention to their knees, legs and ankles until something goes wrong. Once pain sets in, even simple things like walking, climbing stairs, or standing for long can become a real challenge. Left unmanaged, lower limb pain gradually affects mobility, independence and quality of life.

What Is Usually Behind the Pain?

Knee pain commonly traces back to osteoarthritis, ligament injuries, cartilage damage, or years of wear. Pain in the leg can be caused by muscle injuries or conditions involving nerves and poor blood flow. The pain in the ankle is commonly caused by sprains, tendinitis, arthritis, or any injury that may have occurred earlier without complete healing.

Age, obesity, sedentary lifestyles, and constant joint injuries contribute silently to the degenerative condition of the joints.

Signs That Should Not Be Ignored

Persistent pain, swelling, stiffness, or discomfort that keeps getting worse deserves attention. If pain is disturbing your sleep, that is a clear signal to see a doctor.

Habits That Help Protect Your Joints

Walking downstairs puts considerable pressure on the knees, so limiting stair use where possible is sensible. Squatting, sitting on the floor and using Indian-style toilets place similar strain and are better avoided.

Staying active matters just as much. Regular household chores, walking, stretching and strengthening exercises, even 15 to 20 minutes a day, keep muscles strong and reduce the load on joints. Focusing on the adductor muscles around the knee is particularly effective in improving joint support.

Non-Surgical Options Worth Knowing

Surgery is not always the answer. Two non-surgical treatments carried out by a pain physician can make a meaningful difference.

Platelet-Rich Plasma therapy, or PRP, involves concentrating platelets from the patient's own blood and injecting them into the affected joint. In osteoarthritis, where cartilage gradually thins, PRP may help support regeneration and ease symptoms.

Radiofrequency Ablation, or RFA, uses a specialized needle to deliver targeted heat that interrupts the nerves responsible for sending pain signals to the brain. Relief typically lasts one to two years. The procedure is done as day care with no cuts, no stitches and no anesthesia required.

A concern many patients raise is that pain stops them from exercising or losing weight. Once pain is controlled through these treatments, walking and light activity become manageable again, which in turn supports weight loss and takes further pressure off the joints.

Custom Knee Supports

Off-the-shelf knee caps have limited effectiveness. A custom-made support, designed to redistribute body weight and reduce joint stress, works considerably better, especially in early arthritis. Many patients notice relief shortly after wearing one. They are an investment, but a worthwhile one that can reduce dependence on medication while the surrounding muscles gradually strengthen.

When to See a Doctor

If pain has lasted several weeks, is worsening, or is getting in the way of daily life, it is time to consult a specialist. Early diagnosis and the right treatment can protect joint function, restore mobility and often avoid the need for surgery.

(By Dr. Aanchal Sharma, Pain Physician, Principal Consultant and Head of Department, Department of Pain Medicine at BLK MAX Hospital, New Delhi)