From the Guidelines
Aspirin can cause or worsen GERD (gastroesophageal reflux disease) due to its potential to irritate the stomach and esophageal lining. Aspirin belongs to a class of medications called NSAIDs (non-steroidal anti-inflammatory drugs) which can inhibit protective prostaglandins in the stomach that normally help maintain the mucous barrier protecting the stomach lining 1. Regular aspirin use, especially at higher doses, can damage the esophageal and stomach mucosa, leading to increased acid reflux symptoms like heartburn, chest pain, and regurgitation. Some key points to consider:
- Aspirin therapy may be associated with gastritis, epigastric pain, or gastrointestinal bleeding 1.
- Using an enteric-coated aspirin and other modes of gastrointestinal prophylaxis may be considered to reduce stomach irritation.
- For those who must continue aspirin therapy, proton pump inhibitors or H2 blockers might be prescribed alongside to manage GERD symptoms, as they have been shown to be effective in preventing NSAID-related gastric ulcers and reducing the risk of upper GI bleeding 1. If you need to take aspirin for cardiovascular protection or pain relief but experience GERD symptoms, consider discussing with your doctor about alternative medications or strategies to minimize the risk of GERD, such as taking aspirin with food or using a proton pump inhibitor. It is essential to weigh the benefits of aspirin therapy against the potential risks, particularly in patients with a history of gastrointestinal issues or those who are at high risk of bleeding complications 1. If you develop persistent heartburn, difficulty swallowing, or chest pain while taking aspirin, consult your healthcare provider promptly to determine the best course of action.
From the FDA Drug Label
Warnings ... Stomach bleeding warning: This product contains an NSAID, which may cause severe stomach bleeding The FDA drug label does not answer the question.
From the Research
Aspirin Use and GERD
- There is evidence to suggest that certain medications, including anti-inflammatory agents and acetylsalicylic acid (aspirin), may contribute to the development or exacerbation of gastroesophageal reflux disease (GERD) 2.
- Aspirin can cause mucosal damage, reduce lower esophageal sphincter pressure (LESP), or affect esophagogastric motility, leading to GERD symptoms 2.
- A systematic literature review found associations between GERD and medications, including aspirin, although the exact mechanisms and relationships are not fully understood 2.
Mechanisms and Relationships
- The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) can lead to the emergence of GERD symptoms by directly causing mucosal damage or affecting esophagogastric motility 2.
- Reduced LESP and altered esophagogastric motility can contribute to the development of GERD, and aspirin use may exacerbate these conditions 2.
- Further research is needed to fully understand the relationships between aspirin use, GERD, and other medications, as well as the underlying mechanisms and potential risk factors 2.
Clinical Implications
- Healthcare providers should be aware of the potential relationships between aspirin use and GERD, and consider these factors when evaluating and managing patients with GERD symptoms 2.
- Patients taking aspirin or other medications that may contribute to GERD should be monitored for symptoms and adjusted as needed to minimize the risk of developing or exacerbating GERD 2.