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aspirin and gastrointestinal bleeding

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7641. Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. (Abstract)

Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin. Limited data exist on the role of aspirin in increasing the risk of clinically significant postpolypectomy bleeding (PPB), which is defined as lower gastrointestinal (GI) hemorrhage following colonoscopic polyp removal requiring transfusion, hospitalization, endoscopic intervention, angiography, or surgery.To determine if aspirin use prior to colonoscopy increases the risk of clinically significant PPB.A case-control (...) with aspirin use.During the study period, 20,636 patients underwent colonoscopy with polypectomy at the two institutions and 101 patients presented with clinically significant PPB. Twenty patients were excluded from analysis because of prior anticoagulant use. The remaining 81 patients were matched to 81 patients who had undergone colonoscopy without complications. The two groups were comparable in terms of polyp size (97%< or = 10 mm, bleeding group; 95%< or = 10 mm, control group). Aspirin use prior

2004 American Journal of Gastroenterology

7642. Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications. (Abstract)

receptor antagonists have had on population rates of hospitalization and mortality from GI toxicity. This study examines trends in hospitalization and mortality rates from GI toxicity during the 1990s.We performed an analysis of secular trends of hospitalization and mortality rates from peptic ulcer disease, upper GI bleeding, and any GI bleeding using data from the National Hospital Discharge Survey, comparing them with sales of NSAIDs, aspirin, and acid suppression medications from 1992 to 1999.From (...) Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause peptic ulcer disease and upper GI bleeding. Acid suppression medications effectively treat NSAID-induced ulcers. However, it is unknown what effect the availability of proton pump inhibitors and over-the-counter preparations of NSAIDs and histamine type 2

2002 American Journal of Gastroenterology

7643. Clopidogrel plus omeprazole compared with aspirin plus omeprazole for aspirin-induced symptomatic peptic ulcers/erosions with low to moderate bleeding/re-bleeding risk -- a single-blind, randomized controlled study. (Abstract)

Clopidogrel plus omeprazole compared with aspirin plus omeprazole for aspirin-induced symptomatic peptic ulcers/erosions with low to moderate bleeding/re-bleeding risk -- a single-blind, randomized controlled study. Clopidogrel causes significantly less symptomatic peptic ulcer disease and gastrointestinal bleeding than low-dose aspirin in average-risk patients. The gastrotoxicity of clopidogrel in patients with active peptic ulcer disease is unknown.To compare the incidence of unhealed ulcers (...) in patients receiving clopidogrel or aspirin.Patients with aspirin-induced peptic ulcer disease treated with omeprazole (20 mg/day) were randomized to receive clopidogrel (75 mg/day) or to continue with low-dose aspirin. Success was defined as ulcer/erosion healing at the eighth week.One hundred and twenty-nine patients were recruited (69 received clopidogrel and 60 continued with aspirin). Thirty-one (45%) in the clopidogrel group and 25 (42%) in the aspirin group had a minor gastrointestinal bleed

2004 Alimentary pharmacology & therapeutics Controlled trial quality: uncertain

7644. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. (Abstract)

Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. Many patients who have had upper gastrointestinal bleeding continue to take low-dose aspirin for cardiovascular prophylaxis or other non-steroidal antiinflammatory drugs (NSAIDs) for musculoskeletal pain. It is uncertain whether infection with Helicobacter pylori is a risk factor for bleeding in such patients.We studied patients with a history of upper (...) gastrointestinal bleeding who were infected with H. pylori and who were taking low-dose aspirin or other NSAIDs. We evaluated whether eradication of the infection or omeprazole treatment was more effective in preventing recurrent bleeding. We recruited patients who presented with upper gastrointestinal bleeding that was confirmed by endoscopy. Their ulcers were healed by daily treatment with 20 mg of omeprazole for eight weeks or longer. Then, those who had been taking aspirin were given 80 mg of aspirin daily

2001 NEJM Controlled trial quality: uncertain

7645. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. (Abstract)

odds ratio estimate for aspirin taken at least once during the week before the first symptom was 7.2 (95% confidence interval 5.4-9.6). Non-aspirin NSAIDs associated with upper gastrointestinal bleeding were diclofenac (7.9 [4.3-14.6]), indomethacin (4.9 [2.0-12.2]), naproxen (6.5 [2.2-19.6]), and piroxicam (19.1 [8.2-44.3]). Paracetamol, propyphenazone, and dipyrone did not increase the risk. A previous history of gastrointestinal bleeding or peptic ulcer did not greatly affect odds ratio (...) Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. To assess the risk of upper gastrointestinal bleeding associated with the use of individual non-narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), a multicentre study of 875 cases of upper gastrointestinal bleeding and 2682 hospital controls was done. With control for confounding factors, the overall

1991 Lancet Controlled trial quality: uncertain

7646. A Study to Assess the Efficacy and Safety of Enteric-Coated Acetylsalicylic Acid in Patients at Moderate Risk of Cardiovascular Disease

and may receive treatment for the underlying risk factors as defined by the treating physician. Outcome events will be adjudicated by an Endpoint Adjudication Committee and the study will be monitored by an independent Data Safety Monitoring Board. Condition or disease Intervention/treatment Phase Moderate Risk of CVD Drug: Aspirin (Acetylsalicylic acid, BAYE4465) Drug: Placebo Phase 3 Detailed Description: Summary of substantial Protocol amendments Amendment #2 from 09-APR-2008: Systolic blood (...) to the study drug, e.g. hypersensitivity to acetylsalicylic acid Recent (in the past year) history of gastrointestinal or genitourinary bleeding or other bleeding disorders Active diagnosed and documented reflux esophagitis Patients presenting with any medical condition, or psychiatric or substance abuse disorder, that, in the opinion of the investigator, is likely to affect the patient's ability to complete the study or precludes the patient's participation in the study Lactating women or women

2007 Clinical Trials

7647. Study of Esomeprazole 20 mg or 40 mg vs Placebo Effectiveness on the Occurrence of Peptic Ulcers in Subjects on Low Dose Acetylsalicylic Acid (LDA)

Inclusion Criteria: Daily intake of low-dose Aspirin (ASA) - The subject must fulfill at least one of the following (a-e): Aged ≥65 years. Aged ≥18 years and with a documented history of uncomplicated peptic ulcer(s). Aged ≥60 years and naïve to low-dose ASA (ie, treatment started within 1 month prior to randomization). Aged ≥60 years and with stable coronary artery disease. Aged ≥60 years and with complaints of upper gastrointestinal (GI) symptoms that, as judged by the investigator, requires (...) Diseases Intestinal Diseases Gastrointestinal Diseases Digestive System Diseases Stomach Diseases Esomeprazole Aspirin Anti-Ulcer Agents Gastrointestinal Agents Proton Pump Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Anti-Inflammatory Agents Antirheumatic Agents Fibrinolytic Agents Fibrin Modulating Agents

2007 Clinical Trials

7648. Pro-haemorrhagic effects of calcium antagonists: a comparison of isradipine and atenolol on ex vivo platelet function in hypertensive subjects. (Abstract)

Pro-haemorrhagic effects of calcium antagonists: a comparison of isradipine and atenolol on ex vivo platelet function in hypertensive subjects. It has been suggested that long term treatment with calcium antagonist drugs might inhibit platelet function and lead to an anti-atheromatous effect. However recent data have also suggested that such an effect might increase mortality due to an increased incidence of gastrointestinal bleeding. We identified 43 subjects from general practice (...) with uncomplicated mild to moderate hypertension to compare the effects of the calcium antagonist isradipine with that of the beta-blocker atenolol on platelet function, plasma beta-thromboglobulin levels, fibrinolysis, and serum lipids in a randomised double-blind parallel group study. After careful evaluation to exclude concomitant aspirin use, only 24 subjects were eligible to enter the study. While isradipine and atenolol produced comparable and clinically significant falls in blood pressure (167 +/- 2/102

1997 Journal of human hypertension Controlled trial quality: uncertain

7649. Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo-oxygenase-2 inhibitors, traditional non-aspirin non-steroidal anti-inflammatory drugs, aspirin and combinations. Full Text available with Trip Pro

Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo-oxygenase-2 inhibitors, traditional non-aspirin non-steroidal anti-inflammatory drugs, aspirin and combinations. The risks and benefits of coxibs, non-steroidal anti-inflammatory drugs (NSAIDs), and aspirin treatment are under intense debate.To determine the risk of peptic ulcer upper gastrointestinal bleeding (UGIB) associated with the use of coxibs, traditional NSAIDs, aspirin or combinations of these drugs (...) in clinical practice.A hospital-based, case-control study in the general community of patients from the National Health System in Spain. The study included 2777 consecutive patients with endoscopy-proved major UGIB because of the peptic lesions and 5532 controls matched by age, hospital and month of admission. Adjusted relative risk (adj RR) of UGIB determined by conditional logistic regression analysis is provided.Use of non-aspirin-NSAIDs increased the risk of UGIB (adj RR 5.3; 95% confidence interval

2006 Gut

7650. A comparison between gastrointestinal blood loss caused by tilcotil (Ro 12-0068) and aspirin in normal volunteers. (Abstract)

A comparison between gastrointestinal blood loss caused by tilcotil (Ro 12-0068) and aspirin in normal volunteers. An open crossover study was carried out in 6 normal volunteers to measure faecal blood loss caused by tilcotil (Ro 12-0068), a new anti-inflammatory drug, compared with that caused by enteric-coated aspirin. Subjects were allocated at random to receive either single doses of 20 mg tilcotil daily or 900 mg aspirin 4-times daily, reducing to a maximum tolerated dose, over a period (...) of 2 weeks before being crossed over to the alternative medication for a further 2 weeks. Faecal specimens passed during 4 consecutive days in a run-in-period of 1 week, in each treatment period, and in the 2 weeks after the finish of drug therapy were analyzed for blood using a radioactive labelling method. The results showed that faecal blood loss was lower and it did not produce any haematological or biochemical abnormalities or any increase in urinary N-acetyl-beta-glucosaminidase activity

1982 Current medical research and opinion Controlled trial quality: uncertain

7651. Gastrointestinal blood loss of oxaprozin and aspirin with placebo control. (Abstract)

Gastrointestinal blood loss of oxaprozin and aspirin with placebo control. The objective of this study was to compare the effects of oxaprozin (4,5-diphenyl-2-oxazolepropionic acid), a nonsteroidal, antiinflammatory compound, and aspirin in a double-blind, placebo-controlled study to estimate gastrointestinal bleeding. The determination of fecal blood loss was made quantitatively by the use of the radioactive (51Cr) technique. During the first week, subjects were controlled with and without (...) the active treatment period, weeks 3 and 4, there were statistically significant differences among the three groups. The mean blood loss during week 3 was significantly greater for the aspirin group, 8.8 ml/day, than the oxaprozin group, 3.3 ml/day (P less than 0.05), and the placebo group, 1.4 ml/day (P less than 0.001). The smaller difference between oxaprozin and placebo was also significant (P less than 0.05). During the fourth week, the mean daily blood loss among oxaprozin patients had decreased

1982 Journal of clinical pharmacology Controlled trial quality: uncertain

7652. Enteric-coated pelletized aspirin. Gastrointestinal blood loss and bioavailability. (Abstract)

Enteric-coated pelletized aspirin. Gastrointestinal blood loss and bioavailability. Eleven patients suffering from arthritis received, in a randomized cross-over study, anti-inflammatory doses of two aspirin formulations: Enpryn, capsules containing enteric-coated pellets; Rhusal, an enteric-coated tablet. No significant difference was found between the two formulations with respect to gastrointestinal microbleeding, plasma salicylate levels and urinary recovery of salicylate. Bioavailability

1981 The Medical journal of Australia Controlled trial quality: uncertain

7653. Radiochromium (chromium-51) evaluation of gastrointestinal blood loss associated with placebo, aspirin, and nabumetone. (Abstract)

Radiochromium (chromium-51) evaluation of gastrointestinal blood loss associated with placebo, aspirin, and nabumetone. Gastrointestinal blood loss is one of the most serious clinical events induced by drugs. To date, almost no nonsteroidal anti-inflammatory drug has been shown to be devoid of that side effect in a strictly controlled study. The objective of this study was to assess quantitatively, by use of radioactive chromium (chromium-51)-labeled red blood cells, gastrointestinal blood loss (...) associated with nabumetone (1,000 mg daily), aspirin (3.6 g daily), and placebo. A total of 37 normal subjects, divided among the three treatment groups and a fourth group that received no treatment, were assessed clinically and quantitatively for gastrointestinal blood loss over a period of 28 days of "active" treatment. The results with chromium-51, analyzed on a logarithmic scale, revealed no statistically significant differences between the nabumetone, placebo, and control groups. Gastrointestinal

1987 The American journal of medicine

7654. Role of misoprostol in reducing aspirin-induced gastrointestinal blood loss in arthritic patients. (Abstract)

of prostaglandin E1, in preventing gastrointestinal blood loss induced by acetylsalicylic acid in patients with degenerative joint disease. Forty-five arthritic patients (22 women and 23 men) were admitted to the study. All patients had received treatment with 3,900 mg of acetylsalicylic acid per day in four divided doses for at least two weeks and continued to receive that regimen for the duration of the study. Red blood cells were tagged with chromium-51, and fecal blood loss was determined from Days 4 to 7 (...) Role of misoprostol in reducing aspirin-induced gastrointestinal blood loss in arthritic patients. Nonsteroidal anti-inflammatory drugs are used to control pain and inflammation in arthritic disorders. When used at recommended anti-inflammatory dose levels, however, they often produce injury to the gastric and duodenal mucosa and concomitant blood loss. A double-blind, parallel, placebo-controlled study was conducted to assess the effectiveness of misoprostol, a synthetic analogue

1987 The American journal of medicine Controlled trial quality: uncertain

7655. Comparative gastrointestinal blood loss associated with placebo, aspirin, and nabumetone as assessed by radiochromium (51Cr). (Abstract)

(acetylsalicylic acid, ASA), and placebo in a double blind parallel study using chromium 51Cr labelled red cells to quantitate fecal blood loss (FBL) in healthy volunteers. Thirty subjects were randomized to treatment with nabumetone (2000 mg), ASA (3.6 g) or placebo for 21 days following a 7 day placebo period. Six subjects served as untreated controls. FBL in nabumetone treated subjects was not significantly different to placebo or untreated subjects. In contrast, ASA-treated subjects exhibited significantly (...) Comparative gastrointestinal blood loss associated with placebo, aspirin, and nabumetone as assessed by radiochromium (51Cr). Nabumetone differs from most other nonsteroidal anti-inflammatory drugs. It is presented to the gut as a nonacidic prodrug, and is metabolized to its active form after absorption. Studies in animals and humans suggest it is less irritating to the gastrointestinal mucosa. This study compared the gastrointestinal microbleeding induced by nabumetone to aspirin

1989 Journal of clinical pharmacology Controlled trial quality: uncertain

7656. Gastrointestinal blood loss from a new buffered aspirin (Ostoprin): measurement by radiochromium and Hemoquant techniques. (Abstract)

Gastrointestinal blood loss from a new buffered aspirin (Ostoprin): measurement by radiochromium and Hemoquant techniques. Occult gastrointestinal blood loss induced by a new buffered aspirin preparation (Ostoprin, 4.0 g per day) was compared with that from an enteric-coated aspirin (Ecotrin, 3.9 g per day) in 40 patients with osteoarthritis. Blood loss was measured by the radiochromium method and compared with the HemoQuant assay of fecal heme and heme-derived porphyrins. By radiochromium (...) , mean daily blood loss during the first week of treatment with Ostoprin increased 1.6 ml above basal compared to 0.8 ml above basal with Ecotrin (p = 0.06). When aspirin was ceased, blood loss returned more rapidly towards normal in the Ostoprin group (p less than 0.01). By HemoQuant, mean fecal hemeporphyrin excretion rose 0.63 mg hemoglobin equivalent per g feces during the first week of treatment by Ostoprin compared with 0.40 mg/g for Ecotrin (p = 0.06). There was a significant linear

1989 Australian and New Zealand journal of medicine Controlled trial quality: uncertain

7657. Gastrointestinal blood loss induced by bromfenac sodium, aspirin, and placebo. (Abstract)

Gastrointestinal blood loss induced by bromfenac sodium, aspirin, and placebo. The effects of bromfenac sodium, aspirin, and placebo on gastrointestinal (GI) blood loss were compared. In a 22-day, randomized study, healthy men received treatment with either bromfenac sodium 300 mg/d, aspirin 3900 mg/d, or placebo for 10 days. On days 3 through 9 and days 20 through 22, all patients received placebo. Fecal blood was measured using the chromium 51-labeled red blood cell technique. Thirty-seven (...) that bromfenac sodium 300 mg/d, a higher daily dose than the proposed daily dose, causes significantly less GI blood loss than aspirin 3900 mg/d.

1996 Clinical therapeutics Controlled trial quality: uncertain

7658. Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration. (Abstract)

Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration. The purpose of this study was to assess gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin.A total of 47 healthy volunteers participated in randomized, controlled acute and chronic trials. Seventeen participated in a repeated measures acute trial, and 30 participated in an independent sample chronic trial. Gastrointestinal blood loss was determined by obtaining 72 (...) -hour stool collections and quantitating Chromium-51 labeled erythrocytes.Acute phase trials: gastrointestinal blood loss during base line was 0.47 (+/- 0.11) mL/day, 0.96 (+/- 0.12) mL/day with enteric-coated aspirin (p < 0.0006), and 1.82 (+/- 0.35) mL/day with plain aspirin (p < 0.0001 vs. base line, p = 0.0476 vs. enteric-coated aspirin). Chronic phase trials: gastrointestinal blood loss was 1.12 (+/- 0.31) mL/day with enteric-coated aspirin (p = 0.0024 vs. control) and 2.60 (+/- 0.68

1995 The American journal of gastroenterology Controlled trial quality: uncertain

7659. Increased use of selective serotonin reuptake inhibitors in patients admitted with gastrointestinal haemorrhage: a multicentre retrospective analysis. (Abstract)

Increased use of selective serotonin reuptake inhibitors in patients admitted with gastrointestinal haemorrhage: a multicentre retrospective analysis. Selective serotonin reuptake inhibitors (SSRIs) can adversely affect platelet function and impair haemostasis. Various bleeding complications have been reported in persons taking SSRIs including an increased risk of gastrointestinal haemorrhage (GIH).To evaluate SSRI use in patients hospitalized with GIH compared with controls.A retrospective (...) , multicentre case-control study determined use of SSRIs, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, clopidogrel, coumadin and enoxaparin in patients admitted with GIH and age- and sex-matched controls. Exclusion criteria included liver disease, portal hypertension or bleeding diathesis.A total of 579 cases were matched with 1000 controls. SSRI use was 19.2% in cases and 13.6% in controls [OR (95% CI) = 1.5 (1.2-2.0); P = 0.003]. NSAIDs were used by 7.3% of cases and 3.8% of controls [OR = 2.0

2006 Alimentary Pharmacology & Therapeutics

7660. Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin

@tripdatabase.com Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin/warfarin? We searched the NLH Specialist Libraries for Cardiovascular Diseases, Gastroenterology and Liver Diseases as well as the TRIP and Medline databases but found no guidelines or studies examining the effectiveness of proton pump inhibitors to reduce gastrointestinal side-effects (...) Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin/warfarin? - Trip Database or use your Google+ account Find evidence fast ALL of these words

2007 TRIP Answers

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