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12/23/2009 - News

Avoid Aspirin After Peptic Ulcer Bleeding

By: June Chen, MD


Many middle-aged and older adults take aspirin to help prevent heart attacks and stroke. Aspirin is associated with a risk of peptic ulcer bleeding, bleeding in the stomach or upper digestive tract. Bleeding peptic ulcers are typically treated with endoscopic therapy to control active bleeding, medications to suppress stomach acid, and discontinuation of aspirin therapy until the ulcer heals. However, it is not known whether continuing aspirin therapy would increase the risk for recurrent ulcer bleeding.

In a study published ahead of print in Annals of Internal Medicine, researchers report that continuing aspirin after having a bleeding ulcer increase the short-term risk of recurrent bleeding, even in adults who are treated with medications to suppress stomach acid. They studied 150 adults with peptic ulcer bleeding, all of whom had a history of cardiovascular disease and aspirin therapy for heart attack or stroke prevention. Study participants all received endoscopic therapy to stop active bleeding and pantoprazole, a proton-pump inhibitor, to suppress stomach acid. Then, they were randomly assigned to received low-dose aspirin or a placebo pill for 8 weeks. Twice as many patients who received aspirin had recurrent ulcer bleeding than those who received placebo. However, fewer participants who received aspirin died.

Although this study was small and the follow-up duration was short, it does highlight the possible risks and benefits of continuing aspirin therapy after bleeding ulcer in patients at risk for heart attack and stroke. The decision of whether or not to continue taking aspirin after a bleeding ulcer must balance the risk of heart attack or stroke with the risk of recurrent ulcer bleeding.


Annals of Internal Medicine, Published Ahead of Print 30 November 2009.


Created on: 12/15/2009
Reviewed on: 12/23/2009

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