How much more ulcerogenic is plain aspirin compared to EC ASA, enteric-coated aspirin?
We see many ulcer patients who were taking enteric-coated aspirin. The enteric coating prevents the medication from dissolving in the stomach. But once it passes the stomach, reaching the duodenum, it does dissolve, potentially causing an ulcer. The enteric coating may be protective to the stomach. But there is also a systemic effect. Even if you took aspirin intravenously, entirely bypassing the stomach, you would still inhibit the prostaglandin-mediated protection. Are you seeing an increased incidence of bleeding ulcers given that family doctors widely prescribe coated aspirin for cardiac prophylaxis? No, we do not see an increased burden. Most of the time 81 mg of aspirin is used, a very small dose. While even this small dose can lead to stomach damage, it is not as problematic as a higher dose. The number of people who develop ulcers continues to be about 3 to 10 percent of the population. Would you say that NSAIDs are overused in Canada? A lot of nonsteroidal anti-inflammatories
