Syed Irfan Ahmed, Abdul Naeem, Muhammad Naseemullah, Muhammad Habib, Muhammad Hanif.
Upper Gastrointestinal Mucosal injury in Patients on Long-Term, Low-Dose Aspirin Prophylaxis
J Rawal Med Coll Jun 2003;7(1):15-7.
Department of Medicine, Holy Family Hospital and Rawalpindi Medical College, Rawalpindi

Background: To study the effects of low-dose aspirin on upper gastrointestinal mucosa. Methods: Seventy-two patients on long-term prophylactic low-dose aspirin who had upper G.I. symptoms were included in the study. Dose of aspirin varied from 75 to 300mg. Both enteric coated and soluble forms of the drug were studied. Only clinically stable patients were deemed fit for inclusion. All patients underwent upper G.I. endoscopy to look for evidence of mucosal injury in the oesophagus, stomach or duodenum. Results: Endoscopy was normal in 63 out of 72 patients. Of the 9 positive cases, 4 showed patchy erythema which was present in the stomach in three patients and lower oesophagus in one case. Gastric mucosa showed petechiae in two patients. Gastric erosions were noted in two patients and duodenal erosions in one. Those taking a relatively higher dose of aspirin (300mg) or soluble aspirin complained of more symptoms. However, endoscopy did not show a corresponding rise in mucosal njury in them. Conclusion: Low-dose aspirin prophylaxis remains a reasonably safe option, with potential benefits far outweighing the risk of G.I. injury. Both soluble and the enteric coated forms appear to be equally safe in low doses.

Category: Internal Medicine
Keywords: Gastritis. Dyspepsia. Aspirin. Endoscopy. Gastritis Drug Induced. Aspirin Prophylaxis.

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