Male Speaker: Bonnie Larabee has been struggling with rheumatoid arthritis for 30 years. Bonnie Larabee: I get it anywhere from my jaw, in my neck, my shoulders, elbows, well anywhere you have a joint, I guess I could say I've had pain. Male Speaker: Because arthritis pain stems from inflammation, patients like Bonnie often get relief from Non-Steroidal Anti-Inflammatory Drugs or NSAIDS. These include aspirin, ibuprofen and naproxen. Daniel Clauw: The Non-Steroidal Anti-Inflammatory drugs are both analgesics that is they help pain and they are anti-inflammatory. So if you have a pain condition like bursitis or arthritis where there's an element of inflammation then an anti-inflammatory drug will typically work better than just a pure analgesic. Bonnie Larabee: When I took it in the morning, I noticed about an hour or so later I was a little looser and little more able to get around, less pain. Male Speaker: But after 20 years of taking NSAIDS every day, Bonnie sensed trouble. Bonnie Larabee: By the noon or lunchtime, my stomach would be so irritated, and would be like a sore feeling and then I'll get bloated and then it would get crampy. Male Speaker: Her doctor warned her that continuing to take NSAIDS might put her at risk for an ulcer or stomach bleeding. Daniel Clauw: The worst risk of having a side effect of an NSAID occurs with chronic daily use and the longer you take a drug, the higher the dose of the drug that you take, the more likely that you'll develop almost any complication, but certainly the gastric or stomach complications. Male Speaker: The reason for this is that continuous use of NSAIDS wears down the protective lining of the digestive tract, making it more vulnerable to natural stomach acids. While typical stomach ulcers announce themselves with a burning pain in the gut, people who use NSAIDS are in danger of developing stealth ulcers. Patients may have no symptoms until the ulcer causes a frightening complication, such as obstruction, which occurs when swelling from an ulcer closes off the stomach; perforation, which occurs when stomach acids literally eat a hole in the intestinal lining, a serious condition that may require surgery; or internal bleeding, which maybe life-threatening if the patient loses too much blood. James Scheiman: Estimates are that there's over 100,000 hospitalizations every year in the United States related to this problem. Bonnie Larabee: The side effects of having bleeding ulcers and internal bleeding you know that can come on at any given moment and you could be totally unaware that didn't appeal to me. Male Speaker: So Bonnie tries to get by without pain medication most days. Tom Oddi: Right there, this spot. Male Speaker: But some patients are reluctant to give up the relief they get with NSAIDS. Tom Oddi is an avid golfer with arthritis in his hip. Tom Oddi: The pain of the stomach versus the ability to play golf, you just weigh one against the other and golf wins. Male Speaker: Fortunately, patients don't necessarily have to choose between living with pain or risking stomach damage. Their doctors can prescribe a second medication, called a proton pump inhibitor, to block the pumps that make stomach acid. Research suggests these drugs reduce the risk of ulcers in people who take NSAIDS every day. James Scheiman: I actually think what's happening is it's preventing the small erosions from coalescing into bigger ulcers. Male Speaker: That makes it less of a dilemma for patients like Tom to stay in the game.