Improving the Gastrointestinal Tolerability of Aspirin in Older People

Figures & data

Table 1 Risk factors for aspirin-induced gastrointestinal complications

• Advancing age

• Female sex

• History of peptic ulcer disease

• Type and dose of NSAID

• Duration of use

• Use of combinations of NSAIDs

• Concomitant use of drugs such as steroids or anticoagulants

Adapted from Aalykke et al (2001); Gallerani et al (2004).

Table 2 Potential strategies to improve tolerability of aspirin in older people

Helicobacter pylori eradication
Coprescription:
–With PPI
–With prostaglandin analog
Improve mucosal protective mechanisms
–Reverse the age-associated decline in mucus thickness
–Improve secretion of mucosal protective molecules, eg,TFF2
Reduce contact time by reversing the age-associated decline in gastric emptying

Abbreviations: PPI, proton pump inhibitor;TTF2, trefoil factor family 2.

Figure 1 Proposed algorithm to improve gastrointestinal tolerance of aspirin in older people.

Abbreviations: PPI, proton pump inhibitor.

Figure 2 Age-related changes in gastrointestinal physiology

AalykkeCLauritsenKEpidemiology of NSAID-related gastroduodenal mucosal injuryBest Pract Res Clin Gastroenterol20011570422

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