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ASPIRINA EN DOSIS BAJAS Y COMPLICACIONES GASTROINTESTINALES

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El riesgo de hemorragia gastrointestinal en pacientes que consumen aspirina parece ser dependiente de la dosis, aunque menor que el observado en los que utilizan antiinflamatorios no esteroides.
lanas9.jpg Autor:
Angel Lanas arbeloa
Columnista Experto de SIIC

Institución:
Jefe de Sección Aparato Digestivo Hospital Clínico "Lozano Blesa"

Artículos publicados por Angel Lanas arbeloa
Coautor
Angel Ferrández Arenas* 
Doctor en Medicina y Cirugía. Hospital Clínico Universitario de Zaragoza e Instituto Aragonés de Ciencias de la Salud.*
Recepción del artículo
20 de Diciembre, 2004 		Aprobación
7 de Febrero, 2005
Primera edición
26 de Agosto, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

ASPIRINA EN DOSIS BAJAS Y COMPLICACIONES GASTROINTESTINALES

Resumen
La utilización de aspirina se asocia con incremento significativo de hemorragia gastrointestinal. Dicho riesgo parece ser dependiente de la dosis y, aunque es menor que el observado para antiinflamatorios no esteroides clásicos, no parece existir una dosis libre de riesgo. Los factores de riesgo no están totalmente definidos aunque la historia previa de úlcera o complicaciones y la infección por Helicobacter pylori parecen ser los más importantes. Si bien la información al respecto continúa siendo escasa debería ofrecerse profilaxis a aquellos pacientes con uno o más factores de riesgo o a aquellos pacientes que presentando mala salud requieran aspirina. Aunque la terapia profiláctica ideal está todavía por definirse, la mejor opción para la profilaxis parecen ser los inhibidores de la bomba de protones, especialmente beneficiosa en los pacientes de alto riesgo. La erradicación de la infección por H. pylori podría ser otra alternativa en la profilaxis aunque hacen falta más estudios que aclaren su papel exacto y en qué población debe aplicarse.

Palabras clave
Hemorragia gastrointestinal, aspirina, úlcera péptica, Helicobacter pylori, antiinflamatorios no esteroides


Artículo completo
(castellano)
Extensión:  +/-7.01 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

ASA-GASTROINTESTINAL COMPLICATIONS AT LOW AND HIGH DOSES

Abstract
The use of aspirin is associated with a significant increase of gastrointestinal bleeding. This risk appears to be dose-dependent and although it is lower than the one observed with classical NSAIDS there is no risk-free dose. Risk factors are poorly described, although a previous history of peptic ulcer or complications as well as Helicobacter pylori infection seem to be the most relevant ones. Patients with one or more risk factors or those with poor health conditions requiring aspirin, should receive prophylaxis, although data concerning such issues is still scarce. The ideal prophylactic strategy has yet to be defined but proton pump inhibitors are the best option available and they are very beneficial in high-risk patients. H. pylori eradication could be a reasonable prophylactic alternative but more studies are needed to clarify the exact role H. pylori has and the population that would benefit from eradication.

Key words
Gastrointestinal bleeding, aspirin, peptic ulcer, Helicobacter pylori, nsaids

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Alergia, Gastroenterología
Relacionadas: Atención Primaria, Cardiología, Farmacología, Hematología, Medicina Farmacéutica, Medicina Interna



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