title: Gastrointestinal adverse effects of short-term aspirin use: a meta-analysis of published randomized controlled trials.
abstract: OBJECTIVE
  Aspirin is widely used for short-term treatment of pain, fever or colds, but there are only limited data regarding the safety of this use. To summarize the available data on this topic, we conducted a meta-analysis of the published clinical trial literature regarding the gastrointestinal adverse effects of short-term use of aspirin in comparison with placebo and other medications commonly used for the same purpose.
  
  
  METHODS
  An extensive literature search identified 119,310 articles regarding possible adverse effects of aspirin, among which 23,131 appeared to possibly include relevant data. An automated text-mining procedure was used to score the references for potential relevance for the meta-analysis. The 3,983 highest-scoring articles were reviewed individually to identify those with data that could be included in this analysis. Ultimately, 78 relevant articles were identified that contained gastrointestinal adverse event data from clinical trials of aspirin versus placebo or an active comparator. Odds ratios (ORs) computed using a Mantel-Haenszel estimator were used to summarize the comparative effects on dyspepsia, nausea/vomiting, and abdominal pain, considered separately and also aggregated as 'minor gastrointestinal events'. Gastrointestinal bleeds, ulcers, and perforations were also investigated.
  
  
  RESULTS
  Data were obtained regarding 19,829 subjects (34 % treated with aspirin, 17 % placebo, and 49 % an active comparator). About half of the aspirin subjects took a single dose. Aspirin was associated with a higher risk of minor gastrointestinal events than placebo or active comparators: the summary ORs were 1.46 (95 % confidence interval [CI] 1.15-1.86) and 1.81 (95 % CI 1.61-2.04), respectively. Ulcers, perforation, and serious bleeding were not seen after use of aspirin or any of the other interventions.
  
  
  CONCLUSIONS
  During short-term use, aspirin is associated with a higher frequency of gastrointestinal complaints than other medications commonly used for treatment of pain, colds, and fever. Serious adverse events were not observed with aspirin or any of the comparators.
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Baron
authors.forename: Stephen
authors.initials: S
authors.lastname: Senn
authors.forename: Michael
authors.initials: M
authors.lastname: Voelker
authors.forename: Angel
authors.initials: A
authors.lastname: Lanas
authors.forename: Irene
authors.initials: I
authors.lastname: Laurora
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Thielemann
authors.forename: Andreas
authors.initials: A
authors.lastname: Brückner
authors.forename: Denis
authors.initials: D
authors.lastname: McCarthy
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects*; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001241:Aspirin