November 2007

Coated aspirin doesn't reduce risk to stomach

The damage that can be done by taking aspirin has been well documented. Its use can cause low‑grade stomach pain or ulcer and even gastrointestinal bleeding severe enough to require a transfusion.

Knowing this, many people take coated or buffered aspirin in the belief that the risks will be lessened. However, a four‑page special report on aspirin in the August 2007 issue of the Harvard Heart Letter notes that such a belief is mistaken ‑‑ the risks are just as great in coated aspirin as in non‑coated pills.

Coated aspirin, also called enteric‑coated aspirin, has been marketed by the pharmaceutical industry as a way to limit the drug's effect on the stomach. For years, it has tried to convince the public that covering aspirin with a coating designed to withstand stomach acids allows it to sail through the stomach untouched and dissolve in the more neutral small intestine.

Yet, contrary to the drug industry's marketing myth, studies show that coasted aspirin has virtually the same effect on the stomach as plain, uncoated aspirin.

The Harvard Heart Letter notes that aspirin doesn't have to be in contact with stomach cells to harm them. Even when the pill dissolves in the intestines, the medicine gets into the bloodstream and is carried to all parts of the body ‑‑ including the cells lining the stomach.

Once there, it blocks the COX‑1 enzyme. Stomach cells need COX‑1 in order to produce compounds that protect them from the powerful acids that digest food.

SOURCE: Harvard Health Publications, July 30, 2007.