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aspirin and gastrointestinal bleeding

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81. Epidemiological evidence for the association of aspirin and acute gastrointestinal bleeding. Full Text available with Trip Pro

Epidemiological evidence for the association of aspirin and acute gastrointestinal bleeding. 4916213 1970 10 07 2018 11 13 0017-5749 11 7 1970 Jul Gut Gut Epidemiological evidence for the association of aspirin and acute gastrointestinal bleeding. 627-34 Langman M J MJ eng Journal Article Review England Gut 2985108R 0017-5749 0 Tablets, Enteric-Coated R16CO5Y76E Aspirin AIM IM Alcohol Drinking Animals Ascorbic Acid Deficiency complications Aspirin administration & dosage adverse effects (...) Gastrointestinal Hemorrhage chemically induced epidemiology Hematemesis chemically induced Humans Melena chemically induced Peptic Ulcer complications Solubility Stomach Ulcer complications Stress, Psychological complications Tablets, Enteric-Coated 44 1970 7 1 1970 7 1 0 1 1970 7 1 0 0 ppublish 4916213 PMC1553067 Gut. 1964 Jun;5:230-6 14178705 J Clin Invest. 1968 Sep;47(9):2169-80 5675432 Am J Med. 1961 Aug;31:259-65 13735596 Lancet. 1969 Jan 25;1(7587):178-80 4178418 Br Med J. 1962 Mar 10;1(5279):675-80

1970 Gut

82. Aspirin and Gastrointestinal Bleeding Full Text available with Trip Pro

Aspirin and Gastrointestinal Bleeding There is no other over-the-counter (OTC) drug having the widespread use of aspirin. Evoking the well-established analgesic, antipyretic, and anti-inflammatory activities with an amazingly low degree of toxicity, its use has increased in this country to the astounding figure of more than 20 tons daily. The observation that comparatively small daily doses of aspirin may serve as a means of preventing certain types of cardiovascular disasters may lead to even (...) more widespread use of the drug. The most frequent untoward side effect of aspirin is gastric discomfort with or without microbleeding. The amount of bleeding is usually quite small but owing to the long interest of the author in buffered aspirin, it is prudent to determine whether or not this action of aspirin is serious.

1978 Journal of the National Medical Association

83. Reduction of aspirin-induced gastrointestinal bleeding with cimetidine. (Abstract)

Reduction of aspirin-induced gastrointestinal bleeding with cimetidine. Aspirin induces gastric mucosal damage and bleeding in the presence of acid. Cimetidine, the histamine H2-receptor antagonist, reduces basal and stimulated acid secretion. Arthritic patients taking fixed doses of aspirin who were found to have aspirin-induced occult gastrointestinal bleeding were given cimetidine in a randomized double blind, crossover study. Autologous 51Cr-labeled blood was measured in 4-day stool

1978 Gastroenterology Controlled trial quality: uncertain

84. The effects of proton pump inhibition on patient-reported severity of dyspepsia when receiving dual anti-platelet therapy with clopidogrel and low-dose aspirin: analysis from the Clopidogrel and the Optimization of Gastrointestinal Events Trial. Full Text available with Trip Pro

The effects of proton pump inhibition on patient-reported severity of dyspepsia when receiving dual anti-platelet therapy with clopidogrel and low-dose aspirin: analysis from the Clopidogrel and the Optimization of Gastrointestinal Events Trial. Dual anti-platelet therapy with clopidogrel and low-dose aspirin increases the risk for gastrointestinal clinical events. Omeprazole has been shown to significantly reduce these events without compromising cardiovascular safety in patients treated (...) with dyspepsia during follow-up.In addition to reducing the risk of gastrointestinal bleeding, statistically significant benefits with prophylactic omeprazole use on both pain and nonpain symptoms were evident at 4 weeks and sustained through 24 weeks. The clinical significance of these overall results is unclear, but greater in patients with pain at baseline.© 2015 John Wiley & Sons Ltd.

2015 Alimentary Pharmacology & Therapeutics Controlled trial quality: uncertain

85. Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. Full Text available with Trip Pro

Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. To determine the preventive effect and safety of proton pump inhibitors (PPIs) in low-dose aspirin (LDA)-associated gastrointestinal (GI) ulcers and bleeding.We searched MEDLINE, EMBASE and the Cochrane Controlled Trials Register from inception to December 2013, and checked conference abstracts of randomized controlled trials (RCTs) on the effect of PPIs in reducing adverse GI events (hemorrhage (...) , ulcer, perforation, or obstruction) in patients taking LDA. The preventive effects of PPIs were compared with the control group [taking placebo, a cytoprotective agent, or an H2 receptor antagonist (H2RA)] in LDA-associated upper GI injuries. The meta-analysis was performed using RevMan 5.1 software.We evaluated 8780 participants in 10 RCTs. The meta-analysis showed that PPIs decreased the risk of LDA-associated upper GI ulcers (OR = 0.16; 95%CI: 0.12-0.23) and bleeding (OR = 0.27; 95%CI: 0.16-0.43

2015 World journal of gastroenterology : WJG

86. PPI versus Histamine H2 Receptor Antagonists for Prevention of Upper Gastrointestinal Injury Associated with Low-Dose Aspirin: Systematic Review and Meta-analysis. Full Text available with Trip Pro

PPI versus Histamine H2 Receptor Antagonists for Prevention of Upper Gastrointestinal Injury Associated with Low-Dose Aspirin: Systematic Review and Meta-analysis. This study compared proton pump inhibitors (PPIs) and histamine H2 receptor antagonists (H2RAs) for prevention of low-dose aspirin (LDA)-related gastrointestinal (GI) erosion, ulcer and bleeding. Electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (...) , Chinese Biomedical Literature Database, and WanFang Data were searched from the date of their establishment to December 31, 2013. Randomized controlled trials comparing PPIs and H2RAs for prevention of GI injury associated with low-dose aspirin (LDA) were collected. Two reviewers independently abstracted studies and patient characteristics and appraised study quality using the Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan 5.1 software. We included nine RCTs involving 1047

2015 PloS one

87. Aspirin and non-aspirin NSAIDs increase risk of colonic diverticular bleeding: a systematic review and meta-analysis. (Abstract)

Aspirin and non-aspirin NSAIDs increase risk of colonic diverticular bleeding: a systematic review and meta-analysis. Lower gastrointestinal bleeding is a frequent cause of hospitalization, particularly in the elderly, and its incidence appears to be on the rise. Colonic diverticular bleeding is the most common form of lower gastrointestinal bleeding and is responsible for 30-40 % of bleeding episodes. Risk factors associated with diverticular bleeding include obesity, hypertension (...) calculated with fixed-effects and random-effects models. A total of six studies (five case-control studies and one cohort study) met inclusion criteria for analysis. Non-aspirin NSAIDs (NANSAIDs) and aspirin were associated with an increased risk of colonic diverticular bleeding (summary RR = 2.48, 95 % CI 1.86-3.31), with moderate heterogeneity among these studies (P heterogeneity = 0.11, I (2) = 44.4 %). Stratification to evaluate the heterogeneity found that both NANSAIDs (summary RR = 2.24, 95 % CI

2014 Journal of gastroenterology

88. Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding

Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02754960 Recruitment Status : Withdrawn First Posted : April 28, 2016 Last Update Posted : April 28, 2016 Sponsor: Shanghai Jiao Tong University

2016 Clinical Trials

89. ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding. Full Text available with Trip Pro

ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding. This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal bleeding. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based on clinical parameters should be performed to help distinguish patients at high- and low-risk of adverse outcomes. Hematochezia associated (...) with hemodynamic instability may be indicative of an upper gastrointestinal (GI) bleeding source and thus warrants an upper endoscopy. In the majority of patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 h of patient presentation after adequate colon preparation. Endoscopic hemostasis therapy should be provided to patients with high-risk endoscopic stigmata of bleeding including active bleeding, non-bleeding visible vessel, or adherent clot. The endoscopic

2016 American Journal of Gastroenterology

90. New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis (Abstract)

New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis A new generation of oral anticoagulants (nOAC), which includes thrombin and factor Xa inhibitors, has been shown to be effective, but little is known about whether these drugs increase patients' risk for gastrointestinal bleeding (GIB). Patients who require OAC therapy frequently have significant comorbidities and may also take aspirin and/or thienopyridines. We performed a systematic (...) review and meta-analysis of the risk of GIB and clinically relevant bleeding in patients taking nOAC.We queried MEDLINE, EMbase, and the Cochrane library (through July 2012) without language restrictions. We analyzed data from 43 randomized controlled trials (151,578 patients) that compared nOAC (regardless of indication) with standard care for risk of bleeding (19 trials on GIB). Odds ratios (ORs) were estimated using a random-effects model. Heterogeneity was assessed with the Cochran Q test

2013 EvidenceUpdates

91. Acute Middle Gastrointestinal Bleeding Risk Associated with NSAIDs, Antithrombotic Drugs, and PPIs: A Multicenter Case-Control Study Full Text available with Trip Pro

Acute Middle Gastrointestinal Bleeding Risk Associated with NSAIDs, Antithrombotic Drugs, and PPIs: A Multicenter Case-Control Study Middle gastrointestinal bleeding (MGIB) risk has not been fully investigated due to its extremely rare occurrence and the need for multiple endoscopies to exclude upper and lower gastrointestinal bleeding. This study investigated whether MGIB is associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin (LDA), thienopyridines (...) , anticoagulants, and proton-pump inhibitors (PPIs), and whether PPI use affects the interactions between MGIB and antithrombotic drugs.In this multicenter, hospital-based, case-control study, 400 patients underwent upper and lower endoscopy, 80 had acute overt MGIB and 320 had no bleeding and were matched for age and sex as controls (1:4). MGIB was additionally evaluated by capsule and/or double-balloon endoscopy, after excluding upper and lower GI bleeding. Adjusted odds ratios (AOR) for MGIB risk were

2016 PloS one

92. Protons pump inhibitor treatment and lower gastrointestinal bleeding: Balancing risks and benefits Full Text available with Trip Pro

Protons pump inhibitor treatment and lower gastrointestinal bleeding: Balancing risks and benefits Proton pump inhibitors (PPIs) represent a milestone in the treatment of acid-related diseases, and are the mainstay in preventing upper gastrointestinal bleeding in high-risk patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin. However, this beneficial effect does not extend to the lower gastrointestinal tract. PPIs do not prevent NSAID or aspirin-associated (...) lower gastrointestinal bleeding (LGB). PPIs may increase both small bowel injury related to NSAIDs and low-dose aspirin treatment and the risk of LGB. Recent studies suggested that altering intestinal microbiota by PPIs may be involved in the pathogenesis of NSAID-enteropathy. An increase in LGB hospitalization rates may occur more frequently in older patients with more comorbidities and are associated with high hospital resource utilization, longer hospitalization, and increased mortality

2016 World Journal of Gastroenterology

93. Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients Full Text available with Trip Pro

Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients To assess the prevalence of possible risk factors of upper gastrointestinal bleeding (UGIB) and their age-group specific trend among the general population and osteoarthritis patients.We utilized data from the National Health Insurance Service that included claims data and results of the national health check-up program. Comorbid conditions (peptic ulcer, diabetes, liver disease (...) , chronic renal failure, and gastroesophageal reflux disease), concomitant drugs (aspirin, clopidogrel, cilostazol, non-steroidal anti-inflammatory drugs, steroid, anticoagulants, and SSRI), personal habits (smoking, and alcohol consumption) were considered as possible UGIB risk factors. We randomly imputed the prevalence of infection in the data considering the age-specific prevalence of Helicobacter pylori (H. pylori) infection in Korea. The prevalence of various UGIB risk factors and the age-group

2016 World Journal of Gastroenterology

94. Gastrointestinal symptoms in low-dose aspirin users: a comparison between plain and buffered aspirin Full Text available with Trip Pro

Gastrointestinal symptoms in low-dose aspirin users: a comparison between plain and buffered aspirin Aspirin is associated with gastrointestinal side effects such as gastric ulcers, gastric bleeding and dyspepsia. High-dose effervescent calcium carbasalate (ECC), a buffered formulation of aspirin, is associated with reduced gastric toxicity compared with plain aspirin in healthy volunteers, but at lower cardiovascular doses no beneficial effects were observed.To compare the prevalence of self (...) -reported gastrointestinal symptoms between low-dose plain aspirin and ECC.A total of 51,869 questionnaires were sent to a representative sample of the Dutch adult general population in December 2008. Questions about demographics, gastrointestinal symptoms in general and specific symptoms, comorbidity, and medication use including bioequivalent doses of ECC (100 mg) and plain aspirin (80 mg) were stated. We investigated the prevalence of self-reported gastrointestinal symptoms on ECC compared with plain

2014 Netherlands Heart Journal

95. Bleeding

. Also assess whether bleeding is due to local effects (such as blood vessel invasion) or to systemic effects of disease (such as disseminated intravascular coagulopathy [DIC]). Review the need for drugs that increase risk of bleeding e.g. low molecular weight heparin, aspirin, warfarin, dexamethasone, NSAIDS. Management Anticipatory planning If significant bleeding can be anticipated, it is usually best to discuss the possibility with the patient and their family. Ensure carers at home have (...) these. It is reasonable to review need for aspirin and any other drugs with antiplatelet effects, such as many non-steroidal anti-inflammatory drugs (NSAIDs). Consider also if interventions including diathermy, laser, embolisation, radiotherapy, surgery (including endoscopy, bronchoscopy, cystoscopy) are relevant. Assess for appropriateness and need for transfusion or other blood products. Medication Bleeding from skin (including fungating tumours) and mucous membranes Apply direct pressure if possible. This can

2015 Scottish Palliative Care Guidelines

96. Gastrointestinal blood loss. Effect of aspirin, fenoprofen, and acetaminophen in rheumatoid arthritis as determined by sequential gastroscopy and radioactive fecal markers. (Abstract)

Gastrointestinal blood loss. Effect of aspirin, fenoprofen, and acetaminophen in rheumatoid arthritis as determined by sequential gastroscopy and radioactive fecal markers. The feasibility of determining the exact site and amount of drug-induced gastric bleeding was tested. Fourteen patients with rheumatoid arthritis received equivalent therapeutic doses of the antinflammatory drugs aspirin, 4 gm/day, and fenoprofen calcium, 2.4 gm/day, in randomized order for seven days. Acetaminophen (...) was given for 14 days just prior to each of these periods. By fiberoptic gastroscopy, antral ulceration and acute mucosal lesions were found in seven patients following aspirin ingestion, in one taking fenoprofen, and in none taking acetaminophen. Fecal blood loss in four-day stool collections, quantitated by autologous chromium 51-labeled erythrocytes shed into the stool averaged 5.0 ml/day while taking aspirin, 2.2 ml/day while taking fenoprofen calcium, and 0.8 ml/day while taking acetaminophen

1977 JAMA Controlled trial quality: uncertain

97. Early time course of major bleeding on antiplatelet therapy after TIA or ischemic stroke Full Text available with Trip Pro

clopidogrel; rate ratio 1.94, 95% confidence interval 1.24-3.03 for aspirin plus dipyridamole). Incidence rates on aspirin and clopidogrel monotherapy were 2.8 and 2.5 per 100 person-years, respectively, in the first 30 days, with no significant change over time. The time course was similar for gastrointestinal bleeds. There was no early excess of intracranial hemorrhage in patients on either dual or single antiplatelet therapy.Dual antiplatelet therapy is associated with high early risks of major (...) Early time course of major bleeding on antiplatelet therapy after TIA or ischemic stroke To study the early time course of major bleeding and its subtypes in patients with cerebral ischemia on dual and single antiplatelet therapy.We performed a post hoc analysis on individual patient data from 6 randomized clinical trials (Clopidogrel Versus Aspirin in Patients at Risk of Ischaemic Events [CAPRIE], Second European Stroke Prevention Study [ESPS-2], Management of Atherothrombosis With Clopidogrel

2018 EvidenceUpdates

98. Annual Risk of Major Bleeding Among Persons Without Cardiovascular Disease Not Receiving Antiplatelet Therapy. Full Text available with Trip Pro

Annual Risk of Major Bleeding Among Persons Without Cardiovascular Disease Not Receiving Antiplatelet Therapy. A decision to initiate aspirin therapy for primary prevention of cardiovascular disease (CVD) requires consideration of both treatment benefits and harms. The most significant harm associated with aspirin is major bleeding, yet there is a paucity of data on bleeding risk in suitable community populations.To determine the risk of major bleeding among people without CVD who (...) cohort; n=305 057) and after further excluding people receiving other medications associated with increased bleeding risk (nonmedication cohort; n=240 254).Sex and age group in 10-year bands from 30 to 79 years.Risk of a major bleeding event (hospitalization or death associated with bleeding); nonfatal gastrointestinal tract bleeding; and gastrointestinal tract bleeding-related case fatality.Mean participant age was 54 years (SD, 10 years), 44% were women, and 57% were European. Among the 359 166

2018 JAMA

99. Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Rivaroxaban or Warfarin: ROCKET AF Trial. Full Text available with Trip Pro

Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Rivaroxaban or Warfarin: ROCKET AF Trial. Gastrointestinal (GI) bleeding is a common complication of oral anticoagulation.This study evaluated GI bleeding in patients who received at least 1 dose of the study drug in the on-treatment arm of the ROCKET AF (Rivaroxaban Once-daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (...) -years vs. 0.04 events/100 patient-years; 1 fatal events vs. 5 fatal events total). Independent clinical factors most strongly associated with GI bleeding were baseline anemia, history of GI bleeding, and long-term aspirin use.In the ROCKET AF trial, rivaroxaban increased GI bleeding compared with warfarin. The absolute fatality rate from GI bleeding was low and similar in both treatment arms. Our results further illustrate the need for minimizing modifiable risk factors for GI bleeding in patients

2015 Journal of the American College of Cardiology Controlled trial quality: predicted high

100. Effects of Ilaprazole on Ulcer Healing Rate and Prevention of Gastrointestinal Bleeding in the Patients Undergone ESD.

Effects of Ilaprazole on Ulcer Healing Rate and Prevention of Gastrointestinal Bleeding in the Patients Undergone ESD. Effects of Ilaprazole on Ulcer Healing Rate and Prevention of Gastrointestinal Bleeding in the Patients Undergone ESD. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Effects of Ilaprazole on Ulcer Healing Rate and Prevention of Gastrointestinal Bleeding in the Patients Undergone ESD. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02638584 Recruitment Status : Unknown Verified

2015 Clinical Trials

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