Optimal drug therapy after aspirin-induced upper gastrointestinal bleeding

• Published in: European journal of internal medicine 2012-04, Vol.23 (3), p.227-230
• Main Authors: Struijk, M, Postma, D.F, van Tuyl, S.A.C, van de Ree, M.A
• Format: Article
• Language: English
• Subjects: Aspirin; Aspirin - adverse effects; Cardiovascular Diseases - drug therapy; Cardiovascular events; Clopidogrel; Gastrointestinal Hemorrhage - chemically induced; Gastrointestinal Hemorrhage - drug therapy; Gastrointestinal Hemorrhage - epidemiology; Helicobacter pylori; Humans; Internal Medicine; Peptic Ulcer - chemically induced; Peptic Ulcer - drug therapy; Peptic Ulcer - epidemiology; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Proton pump inhibitor; Proton Pump Inhibitors - therapeutic use; Risk Factors; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use; Upper gastrointestinal bleeding
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2011.10.004

Abstract Upper gastrointestinal bleeding is a common adverse effect of chronic aspirin treatment. Traditionally, most physicians might tend to discontinue aspirin therapy after related gastrointestinal bleeding. However, recent studies have shown that continuation of aspirin is beneficial because of a decrease of cardiovascular complications and only a relatively small increase of recurrent peptic ulcer bleeding when combined with a proton pump inhibitor. There might be individual cases where the burden of recurrent gastrointestinal complications outweighs the risk of vascular events. In these cases the physician needs to carefully consider other precipitating factors for the recurrent gastrointestinal symptoms. At the moment, alternative antiplatelet therapy does not lead to lower gastrointestinal risks. In the near future, therapies with a more favorable profile might emerge.