STUART SPECHLER, MD: If you’re taking an NSAID, people often ask, “What are the symptoms that I should alert my doctor about, that I’m having a complication of this medication?” Unfortunately, there are no really good early warning symptoms for the major complications of the NSAIDs. However, if you find that you’re passing black stools, or certainly if you’re passing bloody stools or if you’re throwing up blood or material that looks like coffee grounds -- which is what happens when blood comes into contact with stomach acid, it turns into this coffee ground-looking material -- if you’re having any of those symptoms, you should alert your physician immediately, or even go into the emergency room, because that could be the sign that you’ve developing bleeding, and bleeding from NSAIDs can be very serious. Not only because the NSAIDs themselves can cause the ulcers that are causing the bleeding, but the NSAIDs also often inhibit the ability of platelets, which are clotting factors in your blood, to stop you from bleeding. So it’s a bad combination. Unfortunately, though, most patients who develop a serious complication of NSAIDs, the large majority of those people who have developed serious complications, never had any warning symptoms.
