Endoscopy in asymptomatic minidose aspirin consumers

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Aspirin is a common antiplatelet medication.
• Elderly individuals are particularly susceptible to aspirin-induced gastrointestinal (GI) complications.
• Minidose aspirin (100-325 mg/day) is frequently prescribed, but its GI safety profile in asymptomatic users requires further investigation.

Purpose of the Study:

• To determine the prevalence of upper GI lesions in asymptomatic individuals using minidose aspirin for over 3 months.
• To evaluate the impact of minidose aspirin on the GI mucosa in this population.

Main Methods:

• Prospective, open-label study design.
• Esophagogastroduodenoscopy (EGD) performed on 46 asymptomatic patients (mean age 70 years) taking minidose aspirin.
• Exclusion of patients with pre-existing GI symptoms (e.g., epigastric pain, dyspepsia).

Main Results:

• Nearly half (47.83%) of asymptomatic minidose aspirin users presented with upper GI ulcers or erosions.
• Common findings included erosive gastroduodenitis, gastric ulcers, and duodenal ulcers.
• Helicobacter pylori infection was present in 26% of patients.
• Aspirin use was the only significant predictor of positive endoscopy findings.

Conclusions:

• Minidose aspirin therapy is associated with a high incidence of gastric and duodenal ulcerations, even in asymptomatic individuals.
• The findings underscore the need for careful consideration of GI risks in patients on long-term minidose aspirin therapy.
• Gastroprotective agents were used by only a minority of participants, suggesting a potential area for intervention.