Dish of the Day

Ondokuz Mayıs University (OMU) Faculty of Medicine, Department of Internal Medicine, Assist. Prof. Dr. Özgür Kılıç stated, “In recent years, we have observed significant confusion in society regarding aspirin use. For many years, low-dose aspirin was recommended as a preventive measure for individuals at risk of heart disease. However, recent large-scale and robust scientific studies have shown that routine preventive use of aspirin in individuals who have not experienced a heart attack or stroke often does not provide the expected benefit and may instead pose certain significant risks. Therefore, this approach has largely been abandoned in modern medical guidelines.”

The most important side effect: risk of bleeding

Dr. Kılıç stated: “Aspirin is actually a very important medication. It prevents platelets, which are clotting cells, from sticking together. In this way, it reduces the formation of clots within blood vessels. For this reason, it is widely used to prevent re-occlusion of vessels in patients who have had a heart attack, undergone stent placement, or experienced a stroke. In such cases, aspirin is truly a life-saving drug. However, like all medications, aspirin has side effects in addition to its beneficial effects. One of the most important side effects is the risk of bleeding. It can particularly cause bleeding in the stomach and intestines. Sometimes it may present as major bleeding, while in other cases it may cause unnoticed minor bleeding, leading over time to iron deficiency anemia. For this reason, some patients who use aspirin long-term may present to us with complaints such as fatigue and easy exhaustion. In such cases, we are required to perform tests such as endoscopy and colonoscopy to investigate whether there is bleeding originating from the stomach or intestines. In many cases, the reason for these procedures is the unnecessary use of aspirin. This situation creates both physical and psychological stress for patients and also leads to unnecessary workload and costs for the healthcare system.”

“Even low-dose aspirin can cause serious bleeding”

Noting that aspirin use increased during the pandemic, Dr. Kılıç said: “During that period, some individuals began using aspirin on their own due to the belief that COVID-19 could increase the risk of clotting. However, at this point, aspirin initiated during that time must be reassessed by a specialist physician. Continuing its use unnecessarily is not appropriate. Another issue is the misconception among the public that ‘baby aspirin is harmless.’ The fact that it has a more pleasant taste or a lower dose does not mean that this medication is completely harmless. Even low-dose aspirin can cause serious bleeding. Therefore, the key message is this: aspirin is a very valuable drug, but it is beneficial only when used in the right patient and with the correct indication. It is not appropriate for individuals to use aspirin on their own with the thought of ‘preventing a heart attack.’ Both the initiation and discontinuation of aspirin must be decided by a relevant specialist physician. It should not be forgotten that, like all medications, aspirin has both beneficial and harmful aspects. When used correctly, it saves lives; when used incorrectly, it can lead to serious health problems.”