Peptic ulcers often seen in low-dose aspirin users

NEW YORK (Reuters Health) – About ten percent of patients
taking low-dose aspirin to lower their risk of a heart attack
develop peptic ulcers, which frequently cause no symptoms,
investigators report.

Although aspirin is associated with ulcers, it is unclear
whether patients taking aspirin get ulcers more often, or if
they are just more likely to bleed from ulcers caused by other
factors associated with aspirin’s effects, such as reducing
levels of platelets, cells in the blood responsible for
clotting, Dr. Neville D. Yeomans and colleagues note in their
paper, published in Alimentary Pharmacology and Therapeutics.

To answer this question, Yeomans, a gastroenterologist at
the University of Western Sydney in Australia, and his team
used endoscopy to assess 187 patients who had been taking
aspirin at doses of 75 milligrams to 325 milligrams daily for
at least one month.

The investigators found that the rate of ulcers measuring
at least 3 millimeters in diameter was 10.7 percent. “Only 20
percent had…symptoms, not significantly different from
patients without ulcer,” the team reports.

When they repeated the endoscopy after 3 months among the
113 patients with no ulcers at the beginning of the study, they
found that 7.1 percent of these patients had developed an ulcer
during the interim, which translates to an annual ulcer rate of
28 percent.

Age 70 or older or bacterial infection with H. pylori
raised the risk of an ulcer by about 3-fold, the authors
report. However, smoking, higher aspirin doses, previous ulcer
history and gender did not significantly affect risk.

“Aspirin can be of great benefit to those at high risk of
heart attack or stroke,” Yeomans says in a University press
release, “but the risks as well as the benefits need to be
carefully weighed before embarking on its long-term use in
people who are at only low cardiovascular risk.

SOURCE: Alimentary Pharmacology and Therapeutics, November
2005.