Aspirin 'not to blame' for stomach bleeding – that's due to a bug, say scientists
Thousands of patients are unable to take daily aspirin to prevent heart attack and stroke, because of the risk of stomach bleeding.
Instead, they have to be given more expensive and sometimes less effective treatments.
But, now, scientists have identified what they think is the real cause of stomach bleeding linked to aspirin — a common stomach bug.
Low-dose daily aspirin is a lifesaver, helping to prevent blood clots in the arteries supplying the heart and brain
This new theory could transform the way many people with cardiovascular disease are treated.
It also opens up the possibility that otherwise healthy people, who are currently advised not to take a daily aspirin, because of the risk of bleeding, might be able to take it safely for its cancer-preventing benefits.
Low-dose daily aspirin is a lifesaver, helping to prevent blood clots in the arteries supplying the heart and brain.
It is also prescribed for problems such as atrial fibrillation, a common condition that causes an irregular heartbeat, as this can also lead to the formation of blood clots.
More recently, the drug has also been linked to a lower risk of cancers.
However, it does carry the risk of abdominal pain and stomach bleeds, and for this reason many patients are advised not to take it.
This risk was thought to be due to aspirin directly irritating the stomach lining and causing an ulcer.
Now researchers from Nottingham University believe that helicobacter pylori bacterium (H. pylori), a common stomach bug, may in fact be responsible for the ulcers — and that aspirin merely exacerbates them.
The scientists think treating this problem at the source by eliminating the bacteria would leave more people able to tolerate aspirin, and so reduce their risk of heart attack and stroke.
Scientists have identified what they think is the real cause of stomach bleeding linked to aspirin – a common stomach bug
One in four people is infected with H.pylori at some point, and though many people show no symptoms, it is thought to be the principal cause of stomach ulcers: about three in 20 people infected with it develop a stomach ulcer.
Now research has also linked the bacterium to bleeding from aspirin.
a study by Nottingham University, 60 per cent of patients who suffered
internal bleeding while taking low-dose aspirin tested positive for the
bacterium (H.pylori is detected using a breath test).
the researchers explained: ‘Our hypothesis is that H.pylori causes the
ulcer, and aspirin, by thinning the blood, makes it bleed.
the bacterium is eradicated, the patient will not get an ulcer and
therefore there is no increased bleeding risk with aspirin.’
a new trial of 40,000 UK patients will investigate this. Doctors at
five universities across the UK — Oxford, Durham, Southampton,
Birmingham and Nottingham — will carry out the trial, the Helicobacter
Eradication Aspirin Trial, starting next month and ending in March 2016.
In the study, patients aged 60 and over who are taking low-dose aspirin will first be given the breath test for the H.pylori bacterium.
Those found to be infected will receive a one-week course of eradication drug treatment of strong antibiotics, or a placebo treatment.
Commenting on the study, Dr Jonathan Lyne, a consultant cardiologist who practises in London and at the Mater Private Hospital in Dublin, said: ‘Aspirin is a cornerstone of treatment in almost all patients with vascular disease.
‘Concern in using this drug in those with a history of stomach ulceration and bleeding has always led to consideration of not using it in these patients, or using alternative drugs that may be more expensive and potentially not as effective.
‘Furthermore, the potential cost savings in preventing hospital admissions, investigations and treatments related to ulcers and bleeding caused by aspirin and H.pylori would be welcome not just to patients but to the NHS as a whole.’
In another development, scientists have discovered that chemicals traditionally used in bath salts could help reduce damage caused by stroke.
Magnesium sulphate is thought to dilate arteries in the brain, increasing the amount of vital nutrients reaching any damaged cells.
Animal studies also show it protects nerve cells from damage, though researchers are unclear how it does this.
Previous research has shown that people whose diets are high in magnesium are less likely to suffer a stroke.
Magnesium-rich foods include nuts, green vegetables and beans.
In a U.S. study starting next month, researchers will directly inject the chemical into arteries of 20 stroke patients.
‘Salvage of viable, but threatened, tissue could give stroke patients an increased probability of favourable long-term outcome,’ they said.