EDP column by Dr Ketan Dhatariya

“My brother has been told by his GP to start taking a baby aspirin a day to ‘help his heart’. I always thought that aspirin can cause stomach upset. Am I wrong?"

Aspirin is derived from the bark of a willow tree. It is also known as acetylsalicylic acid. For centuries it was known that willow was good as a pain reliever and was also used to reduce the temperature in someone with a fever. Hippocrates the Greek physician described this in 400 BC. It was in Germany in the 1830’s that chemists began experimenting with plant extracts. It was in 1897 that they were able to make a stable compound which they called aspirin. “A” from acetyl, “spir” from the spirea plant (which yields salicin, the active compund) and "in," a common suffix for medications.

Aspirin has been found to have lots of beneficial effects. These include preventing heart attacks and strokes. They are also given to many people if they are having a heart attack or a stroke as they have been shown to reduce the impact of these potentially fatal condition if it given early. Aspirin works by stopping the blood clotting, so keeping the blood vessels open to allow blood to pass. In a stroke or a heart attack, it is often these blood vessels that are blocked, so that the cells ‘downstream’ are deprived of oxygen. However, as with almost everything in medicine, prevention is better than cure, so low dose (‘baby’) aspirin is used to prevent the blockages happening in the first place. It is often recommended for people who are ‘at risk’ of having heart problems, such as those people over the age of 40, or those with diabetes, or a family history of heart disease. Smokers are also at increased risk and may be advised to use aspirin.

There are additional benefits to using aspirin. Recent studies have shown that long term use of low dose aspirin can also prevent bowel cancer.

All of this makes aspirin sound like a ‘wonder drug’, and it is very useful when used correctly. Your concern about stomach upset is very valid. Aspirin can cause an inflammation of the stomach lining, and in extreme case, may be associated with bleeding and the formation of stomach ulcers. It is therefore very important that aspirin is never taken on an empty stomach. If you have a history of stomach ulcers in the past, then always make you doctor aware of this if they suggest putting you on it. Children under that age of 12 should also not have aspirin, as it can cause liver damage in this age group. Occasionally, aspirin use can be associated with asthma attacks in susceptible people.

In answer to your question, aspirin is a very useful drug that has helped to save numerous lives over the years and has helped relieve pain and fever for centuries before that. However, as with every drug, it should be taken responsibly and under the supervision of your doctor.

For more information about Aspirin/Acetylsalicylic Acid click these links: