title: Optimal drug therapy after aspirin-induced upper gastrointestinal bleeding.
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.
authors.affiliation: Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands. m.struijk@students.uu.nl
authors.forename: M
authors.initials: M
authors.lastname: Struijk
authors.forename: D F
authors.initials: DF
authors.lastname: Postma
authors.forename: S A C
authors.initials: SA
authors.lastname: van Tuyl
authors.forename: M A
authors.initials: MA
authors.lastname: van de Ree
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D000077144:Clopidogrel; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D010437:Peptic Ulcer / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin