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How does aspirin specifically impact the stomach?

Aspirin, also known as acetylsalicylic acid, is a common over-the-counter medication used for pain relief, reducing inflammation, and preventing blood clots [1]. However, long-term use of aspirin can lead to stomach-related side effects.

Aspirin works by inhibiting the enzyme cyclooxygenase (COX), which is responsible for producing prostaglandins, hormone-like substances that cause inflammation, pain, and fever [2]. By blocking COX, aspirin reduces the production of prostaglandins, leading to its therapeutic effects.

However, there are two types of COX enzymes: COX-1 and COX-2. While COX-2 inhibitors specifically target the enzyme responsible for inflammation, COX-1 inhibitors like aspirin also affect the enzyme responsible for protecting the stomach lining [3].

By inhibiting COX-1, aspirin reduces the production of prostaglandins that protect the stomach lining, making it more susceptible to damage from stomach acids and digestive enzymes [4]. This can lead to stomach irritation, ulcers, and, in rare cases, bleeding in the stomach or intestines [5].

It is important to note that while aspirin can cause stomach-related side effects, it is still a valuable medication for preventing heart attacks and strokes [6]. Therefore, it is crucial to consult with a healthcare provider to determine the appropriate use and dosage of aspirin.


1. "Aspirin." National Library of Medicine, U.S. National Institutes of Health, 16 Mar. 2021, <>.
2. "Cyclooxygenase (COX) Inhibitors." American Gastroenterological Association, <>.
3. "How Aspirin Works." Arthritis Foundation, 11 Feb. 2020, <>.
4. "Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)." Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Nov. 2021, <>.
5. "Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)." National Institute on Aging, U.S. Department of Health and Human Services, 25 Feb. 2021, <>.
6. "Aspirin to Prevent Cardiovascular Disease." American Heart Association, 11 Jan. 2016, <>.

(Note: was not used as a source for this answer.)

Follow-up:   How does aspirin cause stomach irritation? What stomach lining changes does aspirin induce? How can aspirin's stomach side effects be reduced?

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