How to Take Aspirin the Safe Way

You've heard that a daily aspirin regime has been shown to help reduce risk of heart attack and stroke. It has also shown promise in the prevention of reducing pancreatic, gastric, and esophageal cancer.

A study published in the November 2011 issue of The Lancet showed that a daily aspirin regime over the course of two years reduced risk of colorectal cancer by 60 percent in patients with Lynch syndrome, who are at high risk for the disease.

Now comes news that colon cancer patients who begin, or continue, a low-dose aspirin regime after diagnosis showed a 30 percent lower risk of death compared to non-users.

So why isn't every one popping a daily aspirin?

The studies are very compelling, says Whitney Jones, MD, Clinical Professor of Medicine at University of Louisville and founder of the Colon Cancer Prevention Project, "but they very clearly state the cornerstone continues to be intensive screening and preventative services, not just aspirin."

In other words, aspirin is not going to replace screening and prevention. And it may not be for everyone.

The Risks of Taking Aspirin

People who have an allergy to aspirin, or have a bleeding or clotting disorder are not good candidates for a daily aspirin regime. In addition, people may experience digestive issues. Aspirin may cause nausea and irritation and increase the risk of bleeding in the gastrointestinal (GI) tract. "From the GI standpoint, aspirin not only has a local effect on the stomach lining, but has a more diffuse effect through the lining of the whole intestinal tract," says Dr. Jones. This can lead to ulcers or erosions in the GI tract's lining.

You also need to be cautious if you're taking other medications. These include:

  • Other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Read labels on all medications to make sure you don't double up on NSAIDs or aspirin. For instance, some over-the-counter cold and flu remedies may contain ibuprofen or aspirin.
  • Medications, such as anticoagulants, corticosteroids, and some antidepressants.
  • Dietary/herbal supplements, including ginkgo and fish oil, as they may increase bleeding risk.

It's important to check with your primary care physician before starting aspirin therapy since there are some conditions that increase your risk of complications. Your doctor should be aware if you:

  • Have a history of ulcers and gastritis
  • Take blood thinners
  • Have an allergy to aspirin
  • Have nasal polyps

A Gentler Way to Take Aspirin

If you have the go-ahead from your primary care physician to start an aspirin regime, but, you find your stomach is not tolerating it well, here's help:

Take a low dose. The side effects of aspirin appear to be dose related, says Jones. The more you take it, the more likely you are to experience GI bleeding, kidney problems, or anything else. But a low-dose regime is pretty benign, he says. According to the Mayo Clinic, doctors prescribe doses from 75 milligrams (mg) to 325 mg. And a very low dose (75 mg), which is less than a baby aspirin, can still be effective.

Try an enteric-coated aspirin. "They help relieve any irritation in the stomach without changing the effect of aspirin," says Jones. He explains that it's gentler on the stomach because the aspirin bypasses the stomach and dissolves in the small intestines instead.

Take aspirin with a meal. Food may serve as a buffer for the medication and alleviate nausea or other irritation.

Don't ignore stomach pain. Aspirin, even in low doses, can cause stomach issues. "If you are taking aspirin, for any reason, and you develop abdominal complaints—pain, discomfort—stop taking the aspirin and discuss your symptoms with your doctor," urges Jones.

A Last Word About Aspirin and Cancer Prevention

The research is very promising, but Jones stresses that aspirin therapy doesn't replace screening and surveillance for colon cancer and colon polyps. "Everybody is looking for a reason not to get a colonoscopy," he says. The American Cancer Society recommends screening for colorectal cancer and polyps begin at age 50 for both men and women, but your doctor may recommend testing earlier if you are at a higher risk.




Whitney Jones, MD, Clinical Professor of Medicine at University of Louisville and founder of the Colon Cancer Prevention Project

Daily Aspirin — More Benefit Than Risk. Medical News Today. March 2012. Web.

Daily Aspirin Therapy: Understand the benefits and risks. Mayo Clinic. April 2012. Web

American Cancer Society Guidelines for the Early Detection of Cancer. March 2012. Web.