Liver-friendly OTC pain medicine?
June 11, 2015 2:13 PM   Subscribe

Are there any effective, over-the-counter pain medicines that are appropriate for someone with liver/pancreas damage?

So I've spent too long drinking, and it's reached the point where I'm doing it for pain management rather than pleasure - I have pains that are likely liver and pancreas related, and I notice that when I don't drink for a couple of days, they gradually lessen, and would presumably go away if given enough time. But because of the pain, it's really, really hard to not drink.

I want to step away from drinking for a long time, but like I said, I'm doing it for pain management at this point, and I'm wondering if there are any truly effective OTC pain medicines that aren't problematic or dangerous for someone who has already punished that part of their body plenty.

Seeing a doctor and/or getting a prescription is not an option, for a variety of reasons. Alternately, are there any dietary things I could be doing that would be like a kindness to my liver/pancreas?

Please assume that this is not a behavioral issue. I would love nothing more than to not drink. It's simply my medicine at this point, and I'm looking for a replacement. Thank you.
posted by anonymous to Health & Fitness (14 answers total)
 
Quell! I ordered it for my fibromyalgia. Still waiting on my unit but it's supposed to be getting fantastic results. From a Facebook user: "I have been wearing the Quell for 5 days now and am pain free after being on gabapentin 6 times a day and tramadol at night. Now I am off both/ It is fantastic."

I should get mine next week so I can give you an update then if you'd like.
posted by no bueno at 2:29 PM on June 11, 2015 [1 favorite]


If you are drinking this much, then you could suffer severe, life-threatening consequences from quitting drinking. No one in good conscience can tell you not to see a doctor about this.
posted by fiercecupcake at 2:53 PM on June 11, 2015 [6 favorites]


I have pains that are likely liver and pancreas related, and I notice that when I don't drink for a couple of days, they gradually lessen, and would presumably go away if given enough time.

This is a super-super dangerous assumption to make. Ongoing abdominal pain is the sort of thing where you should not just be trying to guess what it might be and take OTC pain relievers. It's the sort of thing where it's the symptom of a lot of things that can kill you. You have a lot of organs that do a lot of very important things, and it's not like having a bad knee where you can have something hurt on an ongoing basis and still safely assume that it's probably not something that's going to harm you in the long run. If something is wrong enough to actually be hurting you, you need to see someone ASAP. Being alive is more important than what this does to your finances or reputation.
posted by Sequence at 2:58 PM on June 11, 2015 [7 favorites]


You shouldn't take any of the OTC pain relievers if your drinking is that out of control. Acetaminophen is obviously right out, as it's hard on the liver, but all of the NSAIDs are a bad choice as well as they increase the likelihood of gastrointestinal bleeding, which is a significant risk for people with a history of long-term heavy drinking.

You gotta stop, and you need to see a doctor and see about getting an ultrasound for your liver. Pain from your liver may take a while to subside completely, but it should lessen significantly within a week, anyway. There aren't pain-sensing neurons in the interior of the liver; generally, pain from there comes from the liver swelling and pressing against its capsule. Fatty liver or alcoholic hepatitis can cause that, and they will take some time to subside completely even with total abstinence.

I've heard of doctors prescribing amitriptyline or other drugs that are particularly suited to neuropathic pain for this, but nothing available OTC is safe for you right now (and it probably won't do much for the pain either).

Note that if you attempt to stop on your own and have significant withdrawal symptoms, especially if you notice they get worse rather than better over the first 24 hours, it may be a sign of serious withdrawal that could be dangerous without medical treatment.
posted by mister pointy at 3:00 PM on June 11, 2015 [2 favorites]


If you are drinking this much, then you could suffer severe, life-threatening consequences from quitting drinking. No one in good conscience can tell you not to see a doctor about this

People say this a lot here but I have yet to see a doctor on mefi get quite so anxious about this issue (please correct me if I'm wrong docs). It's fairly rare, though for sure possible, to have seizures and even, rarely, death from alcohol withdrawal. My guess is this is not likely for you but of course I've never met you.

Ibuprofen is eliminated by your kidneys instead of your liver but I think you're going to get a lot of push back on the "there is no way I can see a doctor" score. Your pain could be your liver, but it could be a million other things. There's no way for you to know if your guess is right. Say it is your liver - just stopping drinking might not be enough to treat severe liver disease.

I'm sorry, but it's hard to just answer your question here. You sound like you could use a visit with a respectful medical provider of some kind - to evaluate the real cause of your physical pain.

Also, most people do benefit from outside support when they are quitting alcohol. I wonder if there's some kind of support that might feel most helpful to you?
posted by latkes at 3:04 PM on June 11, 2015 [1 favorite]


I'm an MD. I'm sorry to hear you're going through this. Unfortunately, I do not believe there's an easy answer to be found here, and I think that there's danger to be found in every direction. Here's why:
- You could die from continued drinking. Liver failure is a concern, of course.
- You could die from abstinence: alcohol withdrawal kills. This is not a trivial risk.
- You could die from taking anything at all for pain.
- Tylenol/acetaminophen could kill you as it's metabolized by the liver.
- NSAIDs (Motrin/ibuprofen, Aleve/naprosyn, for example) could kill you as they thin your blood.
- Aspirin could kill you for the same reason.
- You may have esophageal varices which could bleed spontaneously and may kill you.
- You may already be coagulopathic from liver disease. That is: your blood is "thin." Your clotting mechanisms/pathway is borked.

In regards to dietary changes: I cannot provide an answer in good faith without knowing your current state of health, apart from not drinking. And even that is with the huge concern for possible alcohol withdrawal which, as stated above, can kill you. Chronic alcoholism can lead to anemia and vitamin deficiencies, sure, but the bottom line is that I have no idea what's causing your pain, or anything about your pain at all.

TL;DR: there is no OTC pain medication that isn't problematic or dangerous for you. There's no clear answer to dietary changes that would benefit your liver/pancreas apart from careful cessation of alcohol without knowing your state of health.
posted by herrdoktor at 4:52 PM on June 11, 2015 [15 favorites]


Quell is apparently a transcutaneous electrical nerve stimulation device, which is not exactly settled science when it comes to pain relief, and in any case is probably unlikely to help with gut pain (if that's where your pain is).

Nthing to go see a doctor.
posted by Aleyn at 5:32 PM on June 11, 2015 [1 favorite]


I wonder what are the "variety of reasons" that makes going to see a doctor seemingly impossible for you. Perhaps if you can answer through moderators, and we can problem-shoot and help you overcome some of the barriers. As you can see there are no easy answers and your health could be in serious risk already. As hard as it may be to think about getting professional help, you absolutely need it. So I encourage you to reach out, on the internet, or better yet, in real life, to people around you.
posted by Pantalaimon at 6:27 PM on June 11, 2015


I'm a doctor who has posted here to tell people not to stop drinking abruptly if they have symptoms of physical dependence, and each time some idiot has popped up to say "no it's fine I only hallucinated for a few days so it's perfectly safe".

We don't post because it's so annoying, not because there's no problem with stopping drinking abruptly - there absolutely is, it can kill you.

Herrdoktor's advice is spot on.
posted by tinkletown at 3:53 AM on June 12, 2015 [3 favorites]


alright, I withdraw my reassurance! My experience is that people pop in to talk about the danger of suddenly stopping drinking for people who do not seem to be heavy enough drinkers to be at that kind of risk, but I hear two doctors saying otherwise and realize we can't know how much this poster is drinking over the internet.
posted by latkes at 6:18 AM on June 12, 2015 [3 favorites]


And I have just realised it looks like I was calling you an idiot Latkes. I wasn't, I had a specific previous question in mind.
posted by tinkletown at 9:05 AM on June 12, 2015


No problem! Always glad to learn more.
posted by latkes at 2:49 PM on June 12, 2015


Mod note: This is a followup from the asker.
Thank you to everyone who has commented so far. FWIW, there have been several occasions over the past few years (including just a month or so ago) in which I went off the bottle cold-turkey for a week or two, and there were no adverse effects. So I'm not so much worried about that, although that seems to have been the bulk of the responses so far. I'm more interested in finding some ways to ease physical discomfort, so that my lazy and weak self is more likely to stick it out. (I have learned, for instance, that fried foods are my enemy.) Thank you again.
posted by cortex (staff) at 5:59 PM on June 12, 2015


If fried food is the enemy, let me point out that that is a possible symptom of pancreatitis. See a doctor see a doctor see a doctor.
posted by mister pointy at 9:08 PM on June 22, 2015


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