Aspirin-induced gastric injury is more likely when H. pylori is present

המידע באדיבות אתר מדיקונטקסטBy Anthony J. Brown, MD

WESTPORT, CT (Reuters Health) – While aspirin and Helicobacter pylori infection have each been linked to gastric mucosal injury, it seems that these factors also interact to increase the risk of damage.

Dr. Mark Feldman, from the Veterans Affairs Medical Center, in Dallas, and colleagues randomized 29 healthy subjects with H. pylori infection and 32 similar subjects without infection to receive placebo or low-dose aspirin therapy for 45 days.

As reported in the June issue of The American Journal of Gastroenterology, endoscopic examination revealed the presence of aspirin-related erosive disease in 50% of the infected subjects, but only 16% of the uninfected subjects. Furthermore, aspirin caused significantly greater gastric antrum damage in the infected subjects than in the uninfected subjects. In fact, two of the aspirin-treated infected subjects developed antral ulcers, the researchers point out.

The differences in aspirin-induced damage could not be accounted for by differences in prostaglandin synthesis, the authors found, because infected and uninfected subjects showed similar reductions in prostaglandin synthesis.

"These findings indicate that the inflammation that is present with H. pylori infection predisposes to more damage from aspirin," Dr. Feldman told Reuters Health.

"The implication from the current findings is that if you could identify these high-risk patients and eradicate the infection prior to aspirin therapy, you may reduce the risk of significant GI bleeding and other ulcer complications," Dr. Feldman stated. However, a definitive placebo-controlled study investigating this has not been done, he said.

Am J Gastroenterol 2001;96:1751-1757.

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