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The standard does of 325 mg of coated aspirin does not significantly cause gastro-intestinal bleeding
except for those with an existing problem—which is brought on by H. pylori.
Omeprazole (Prilosec OTC), also in the PPI family are Nexium, Esomeparzole magnesium, Zegerid, Prevacid,
Iansopravole, Pantoprazole, Protonix, Rabaprazole, Aciphex, and Biaxin. They
are protein pump inhibitors. Current wisdom is to avoid this more dangerous,
high-priced way of treating heartburn, and take an old-fashioned anti-acid medication.
See https://www.worstpills.org/member/newsletter.cfm?n_id=250
Stomach Bleeding Comparison to Aspirin, other NSAIDs 9 times higher
(1.9:18.8)
Omeprazole is
a proton pump inhibitor (blocks the production of HCl in the stomach 80-95%). Ulcers
are caused by a stomach bacteria H. pylori.
Treatment consists of eradication the bacteria. Following this
half were given the proton pump inhibitor. Both groups then resumed taking either
aspirin or other NSAIDs as befores. The aspirin group faired much better: they had half the stomach bleeds if on Omeprazole, and 1/9th the bleeds
without Omeprazole. This is more evidence concerning the disinformation big PhARMA
has put out about the relative risk of aspirin to other NSAIDs.
NEGM (New England Journal of Medicine)
Preventing Recurrent Upper Gastrointestinal
Bleeding in Patients with Helicobacter pylori Infection Who Are Taking Low-Dose Aspirin or Naproxen
Francis K.L. Chan, M.D., S.C. Sydney Chung, M.D., Bing Yee Suen, R.N., Yuk
Tong Lee, M.D., Wai Keung Leung, M.D., Vincent K.S. Leung, M.D., Justin C.Y. Wu, M.D., James Y.W. Lau, M.D., Yui Hui, M.D.,
Moon Sing Lai, M.D., Henry L.Y. Chan, M.D., and Joseph J.Y. Sung, M.D., Ph.D.
Abstract:
Background Many patients who have had upper gastrointestinal
bleeding continue to take low-dose aspirin for cardiovascular prophylaxis or other nonsteroidal antiinflammatory
drugs (NSAIDs) for musculoskeletal pain. It is uncertain whether infection with Helicobacter pylori
is a risk factor for bleeding in such patients.
Methods We studied patients with a history of upper gastrointestinal
bleeding who were infected with H. pylori and who were taking low-dose aspirin or other NSAIDs. We
evaluated whether eradication of the infection or omeprazole treatment was more effective in preventing
recurrent bleeding. We recruited patients who presented with upper gastrointestinal bleeding that was confirmed
by endoscopy. Their ulcers were healed by daily treatment with 20 mg of omeprazole for eight weeks or longer.
Then, those who had been taking aspirin were given 80 mg of aspirin daily, and those who had been taking
other NSAIDs were given 500 mg of naproxen twice daily for six months. The patients in each group were
then randomly assigned separately to receive 20 mg of omeprazole daily for six months or one week of eradication
therapy, consisting of 120 mg of bismuth subcitrate, 500 mg of tetracycline, and 400 mg of metronidazole,
all given four times daily, followed by placebo for six months.
Results We enrolled 400 patients (250 of whom were taking
aspirin and 150 of whom were taking other NSAIDs). Among those taking aspirin, the probability of recurrent
bleeding during the six-month period was 1.9 percent for patients who received eradication therapy and
0.9 percent for patients who received omeprazole (absolute difference, 1.0 percent; 95 percent confidence interval
for the difference, –1.9 to 3.9 percent). Among users of other NSAIDs, the probability of recurrent
bleeding was 18.8 percent for patients receiving eradication therapy and 4.4 percent for those treated
with omeprazole (absolute difference, 14.4 percent; 95 percent confidence interval for the difference, 4.4
to 24.4 percent; P=0.005).
Conclusions Among patients with H. pylori infection and
a history of upper gastrointestinal bleeding who are taking low-dose aspirin, the eradication of H.
pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding. Omeprazole is superior
to the eradication of H. pylori in preventing recurrent bleeding in patients who are taking other
NSAIDs, such as naproxen.
Coated Aspirin lowers gatric mucosal damage |
Two problems, often
the research has been funded by PHARMA, which in the drive for profits is eager to publicize bleeding with aspirin, but not
with the other NSAIDS. They often use lesions to support their findings; however,
these lesion are not a good The results are often contaminated by the use of other NSAIDs in addition to aspirin. These greatly increase the incident of gastrointestinal bleeding.
For example a Madrid study (pre-publication edition on web, by Francisco J. De Abajo, MD, M.P.H, Division de Farmacoepidemoligia
y Farmacovigilamcia Agencia Espanola del Medicamento, Madrid found for 2,195 UGIC (upper gastrointestional complications)
that the concomitant use of aspirin with high-dose NSAIDs caused a 3 fold increase.
“The concomitant use of low-does aspirin & NSAIDs at high dose put patients at higher risk of UGIC. Published November of 2000. Another problem with PHARMA studies are that they rely
upon endoscopic examination for lesions, “However, it is known that these lesions are not good predictors of major upper
gastro-intestinal bleeding, yielding apparently opposite results” (at p. 4). Of
interest was the find that there was no dose relationship in the 75 to 300 mg range. A drug which causes a side effect will
cause more at a higher dose. It is my recommendation that the higher dose
be taken so as to potentate the cancer protective effect.--JK
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