Why might aspirin cause stomach ulcers?

How does aspirin irritate the stomach lining?

Aspirin blocks an enzyme called cyclooxygenase, which reduces the production of prostaglandins. These compounds normally protect the stomach by keeping blood flow steady and stimulating mucus and bicarbonate secretion. When prostaglandins fall, the stomach becomes more exposed to its own acid and pepsin.

What happens if the stomach loses its natural defenses?

With less mucus and bicarbonate, acid can erode the surface layers of the stomach wall. Over time, shallow breaks turn into deeper sores called ulcers. People who take high doses or use aspirin for long periods face higher risk.

Can other pain relievers cause the same issue?

NSAIDs like ibuprofen and naproxen work the same way by cutting prostaglandin levels. Acetaminophen does not affect prostaglandins in the stomach and therefore does not carry the same ulcer risk.

Who faces the highest risk?

Older adults, smokers, and those already infected with H. pylori are more likely to develop ulcers from aspirin. Patients taking steroids or blood thinners along with aspirin also show elevated rates.

How long does it take for ulcers to develop?

Some people notice symptoms after only a few weeks of regular use. In others, damage builds gradually over months or even years. Regular endoscopic checks can catch early changes before they escalate.

Are enteric-coated or buffered versions safer?

These formulations reduce direct contact with the stomach surface but do not stop the systemic drop in prostaglandins. Studies show they lower immediate irritation but still produce ulcers at similar rates over time.

What treatment steps do doctors recommend once an ulcer forms?

They usually stop or reduce aspirin, prescribe proton-pump inhibitors to lower acid, and test for H. pylori. If the patient needs ongoing aspirin for heart protection, doctors often continue it with a PPI for stomach protection.