Aspirin, or rather acetylsalicylic acid (ASA) it contains, is known, among others for its anticoagulant effect. Many patients are encouraged to take it prophylactically and regularly, even every day, often without consulting a doctor. The consequences can be dire. A man who, in order to avoid a heart attack, contracted such serious ailments that he miraculously survived discovered this. Why did ASA devastate his body?
- Robert Hardman took 75 mg of aspirin daily for seven years. He read on the internet that this is a good way to avoid a heart attack
- One day he felt unwell, but was sure it was a side effect of the vaccine he had taken a few days earlier. However, after calling an ambulance, it turned out that he was bleeding into his stomach and his condition was critical
- – Daily, regular intake of low doses of acetylsalicylic acid (75-81 mg per day) reduces the risk of heart attack and stroke, but only in secondary prevention and in selected people at high and very high cardiovascular risk in primary prevention – explains cardiologist Prof. dr hab. med. Krzysztof J. Filipiak
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From prophylaxis to surgery
The story of Robert Hardman is a good example of how not to use Internet resources – it certainly should not be done quickly and selectively. A few years ago, while looking for health information, a man came across an entry about the beneficial effects of acetylsalicylic acid (ASA, colloquially known as aspirin, although the name is reserved for a product of a specific pharmaceutical company). He said that taking ASA tablets regularly reduces the risk of a heart attack. Without thinking, he reached for the drug, and it became a habit for him to take it.
For seven years, Hardman did not experience any side effects from taking ASA daily. One day, when he was getting on the train, he felt sick – he was sweating and his muscles stiffened, the man felt a distinct weakness. After returning home, he took the temperature, but it was normal. So he decided it was the side effects of the COVID-19 vaccine he had taken a few days earlier. However, that was not the end of the complaints.
«The next morning I felt even worse. A day later – still with no temperature and with some negative coronavirus tests – I collapsed in the bathroom, breaking the towel rail. I barely crawled back to bed »he reported.
The doctor he called for a consultation, suspecting stomach bleeding, immediately called an ambulance, which took the patient to the emergency room. There, the preliminary diagnosis was confirmed, and during the endoscopic examination, two ulcers were noticed in the stomach. The hemorrhage caused a man’s hemoglobin levels to drop in half. Two blood transfusions and a series of drips were required.
Robert Hardman is grateful to his wife who talked him into teleporting. “If I hadn’t, I would have slept with this fever-free” flu “and would bleed to death in the process,” he concludes.
After a short interview, the doctors found the source of the problem with which the patient was hospitalized. It turned out that aspirin is to blame, which – yes – with regular consumption may reduce the risk of a heart attack, but not in all patients.
Daily, regular intake of low doses of acetylsalicylic acid – 75-81 mg / day – reduces the risk of heart attack and stroke, but only in secondary prevention and in selected people at high and very high cardiovascular risk in primary prevention. We’ve known this for decades, and nothing new has medically happened here. The problem is to determine who is in this group. If ASA is taken prophylactically by a lower-risk person, it may happen that the possible side effects of ASA (gastrointestinal bleeding) outweigh the benefits (avoiding heart attack and stroke). Hence, decisions about who should take prophylactic ASA are always made with the patient by the doctor.
Patients with heart disease or after a stroke are often prescribed a low daily dose of acetylsalicylic acid to prevent dangerous blood clots. The difference between them and patients without such a burden is that they are always under the care of a doctor who advises them to be alert to the side effects of taking aspirin, such as indigestion, stomach pain and black stools. They know that such discomfort may be related to the drug being taken and should be consulted immediately with the attending physician.
Why can aspirin be harmful?
As explained by prof. Jeremy Sanderson, gastroenterologist at Guy’s and St Thomas’ NHS Foundation Trust in London, any ingestion of aspirin leads to some kind of “erosion” of the gastric mucosa. ASA blocks the enzymes that produce prostaglandins that protect the lining of the organ, allowing stomach acids and pepsin (a protein-breaking enzyme) to “autodigestion” the lining of the stomach. Ulcers can be the consequence.
It also happens that a small dose of aspirin or another non-steroidal anti-inflammatory drug (e.g. ibuprofen) is harmful. Gastric side effects are frequent when taking ASA, and in particularly sensitive patients with stress, gastric mucosa hemorrhage it can appear even after one or two doses of aspirin. That is why it is so important not to reach for medications without consulting a doctor and not to dose them on your own.
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