Aspirin-induced bleeding: Can getting rid of a bacterium reduce risk?



Thanks to its wide range of medicinal benefits, aspirin is one of the most commonly usedTrusted Source medications in the world.

For decades, aspirin has been used for the prevention of cardiovascular eventsTrusted Source in patients with heart disease. By thinning the blood, aspirin reduces the risk of blood clotting and may prevent a heart attack or a stroke.

The main disadvantage of aspirin use is the risk of serious gastrointestinal bleeding, which can occur even at low dosesTrusted Source. A 2021 clinical trial that enrolled 19,114 participants aged 70 years or older found that aspirin increases the risk of significant gastrointestinal bleeding by 60%.

Previous studiesTrusted Source have demonstrated a strong link between the occurrence of peptic ulcers in patients receiving low-dose aspirin — usually up to 100 milligrams (mg) daily, but may reach 325 mg daily — and the presence of Helicobacter pylori, a bacterium that infects the stomach.

H. pylori infection can result in the formation of peptic ulcers — open sores in the lining of the stomach and duodenum. Doctors believed that the anti-blood-clotting effects of low-dose aspirin increase bleedingTrusted Source from these peptic ulcers.

A team led by researchers from the University of Nottingham in the United Kingdom conducted a large clinical trial to investigate whether the eradication of H. pylori would protect against aspirin-associated ulcer bleeding. The results of this trial appear in The LancetTrusted Source.

“In clinical practice, we see a number of patients who stop taking aspirin due to bleeding issues. So, this is a real issue,” Dr. Khagendra Dahal, interventional cardiologist and assistant professor at Creighton University School of Medicine in Omaha, Nebraska, told Medical News Today.

“This is a large randomized trial and the first one, according [to] the authors, […] to address the issue of H. pylori eradication to prevent aspirin-related gastrointestinal bleeding. So, this is a commendable job to undertake this issue and try to address strategies to reduce gastrointestinal bleeding,” he added.

Between September 2012 and November 2017, at 1,208 primary care centers in the U.K., the researchers recruited patients aged 60 years or older, who were receiving a daily aspirin dose of 325 mg or less, and had a positive urea breath test for H. pylori at screening.

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