What long-term side effects can aspirin cause?
Aspirin can cause side effects that build up over time, especially with regular use and at higher doses. The best-known long-term risk is damage to the stomach and intestines, including chronic irritation, ulcers, and bleeding. Long-term aspirin use can also increase bleeding risk in other parts of the body and contribute to kidney problems in some people.
How does aspirin affect the stomach and intestines over time?
With ongoing use, aspirin can irritate the gastrointestinal tract and reduce protective lining in the stomach and small intestine. This can lead to long-term issues such as:
- Gastritis (chronic stomach irritation)
- Peptic ulcers
- Gastrointestinal bleeding or anemia from slow, ongoing blood loss
These problems are more likely in people who take aspirin daily, use higher doses, have a history of ulcers or GI bleeding, drink alcohol heavily, or also take other medicines that increase bleeding risk.
Does long-term aspirin increase bleeding elsewhere?
Yes. Aspirin makes blood less able to clot, and this effect can raise the risk of bleeding with long-term use. Beyond stomach bleeding, people may also experience easier bruising or bleeding from other sites. The risk tends to be higher if aspirin is combined with other blood-thinning or antiplatelet medicines.
Can aspirin cause kidney problems long-term?
Aspirin and other NSAID-type pain relievers can affect kidney function in some people, particularly those who already have kidney disease, older adults, people who are dehydrated, or those taking other medications that affect blood flow to the kidneys (such as certain blood pressure drugs). Over time, this can worsen kidney function in susceptible individuals.
What about bleeding risk vs. heart-attack and stroke prevention?
Many people take low-dose aspirin long term for prevention of cardiovascular events. The trade-off is that the medication can lower the risk of certain heart and stroke outcomes, but it increases the likelihood of bleeding. Whether aspirin is appropriate depends on a person’s cardiovascular risk and their bleeding risk, including age and prior history of ulcers or bleeding.
Who should be extra cautious with long-term aspirin side effects?
Long-term risks are higher for people with:
- Past stomach ulcers or gastrointestinal bleeding
- A history of bleeding disorders
- Uncontrolled high blood pressure
- Kidney disease
- Heavy alcohol use
- Use of other medicines that raise bleeding risk (such as anticoagulants or certain antiplatelet drugs)
When should someone stop and get medical help?
Get urgent medical care if aspirin use is associated with signs of serious bleeding, such as:
- Black or tarry stools
- Vomiting blood or material that looks like coffee grounds
- Severe or worsening abdominal pain
- Sudden weakness, dizziness, fainting, or signs of stroke/major bleeding
Are there safer alternatives for long-term use?
Depending on why someone takes aspirin (pain relief vs. prevention), alternatives may include different pain strategies, or other cardiovascular prevention approaches that do not rely on long-term aspirin. A clinician can help weigh benefits vs. bleeding risk and decide whether a lower dose, stomach protection (for some people), or a different medication is safer.
Sources are not provided with your prompt. If you want, tell me whether you mean aspirin for pain (higher doses) or low-dose aspirin for heart/stroke prevention, plus your age and any history of ulcers or bleeding, and I’ll tailor the side-effect risks and what to watch for.