• NSAIDs and prostaglandin inhibitors are notorious gastrointestinal irritants, irritating enough to cause ulceration, even though simple caffeine/coffee can cause diarrhea because of its irritant effects. These drugs disrupt the protective mucus layer that surrounds the stomach lining, often puncturing it and causing direct irritation to the stomach tissue itself. The stomach's natural response to this irritation is to empty itself into the duodenum (small intestine). The duodenum is very sensitive to irritation because it is the linchpin of nutrient absorption and when receiving stomachic contents with a high acid content and irritating NSAID remnants, will push the contents into the transverse colon and quickly bypass fecal matter in the lower colon, causing episodic diarrhea. Taking a H2 blocking drug before or with NSAIDs neutralized the reaction with stomach acid and usually prevents this. H2 blockers are ranitidine (Zantac), nizatidine (Axid), famotidine (Pepcid), cimetidine (Tagamet), etc. Taking on a full stomach or with a large (16oz+) glass of water also minimizes the effects.

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