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I get this question almost everyday. "Aspirin is good for my heart but bad for my stomach. What should I do?" The answer to this simple question is how ever not very simple since we are comparing apples and oranges.
Every patient needs to be individualized and trade-off assessed. Having said that, if you are at high risk for ulcers and low risk for heart disease, the cardiac protection by aspirin may not be worth it.
A recent study by Drs. Hernandez-Diaz and Garcia examined estimated risk of gastrointestinal complications due to aspirin among patients in different types of patients. The factors included advanced age, male sex, prior ulcer history and use of non-steroidal anti-inflammatory drugs (NSAIDs).
Is It Leaky Gut or Leaky Gut Syndrome?
They estimated that average excess risk of upper gastrointestinal complications is 5 extra cases per 1,000 aspirin users per year. It is however increased to 10 or even more extra cases per 1,000 person-years in certain high-risk populations.
Take home message: The gastrointestinal complication risk in your case may offset the cardioprotective benefit if your risk of ulcers is high while the cardiovascular risk is low. Because of an element of subjectivity, it is possible that different physicians may come to different conclusions in any particular case.
