Today, aspirin is one of the most widely used medications in the world, with an estimated 40,000 tons of it being consumed each year Â– that is about 40 trillion pills per year, or about 60 pills per person per year. That makes one think that some people are eating them likes sweets at the rate of two a day! But there is a potentially dark side to this pill popping mania.....
Aspirin is a drug which is often used as an way of relieving minor aches and pains, to reduce fever, and as an anti-inflammatory medication.
Aspirin also has an interesting effect on the coagulation of blood platelets in the arteries, by breaking them up. Because the platelet patch can become too large and thus block blood flow, locally and downstream, aspirin is also used long-term, at low doses, to help prevent heart attacks, strokes, and blood clot formation in people at high risk of developing blood clots. It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of heart tissue.
The main undesirable side effects of aspirin taken by mouth are:
• gastro-intestinal ulcers, stomach bleeding, and tinnitus, especially in higher doses.
• In children and adolescents, aspirin is no longer indicated to control flu-like symptoms or the symptoms of chickenpox or other viral illnesses, because of the risk of Reye's syndrome. (a potentially fatal collection of symptoms that cause detrimental effects to many organs, especially the brain and liver as well as causing a lower than usual level of blood sugar.)
Today, aspirin is one of the most widely used medications in the world, with an estimated 40,000 tons of it being consumed each year – that is about 40 trillion pills per year, or about 60 pills per person per year. That makes one think that some people are eating them likes sweets at the rate of two a day!
Aspirin is used for the treatment of a number of conditions including:
• rheumatic fever
• inflammatory diseases such as rheumatoid arthritis
• inflammation of the lining of the heart
• Kawasaki disease. (An acute disease of young children characterized by a rash and swollen lymph nodes and fever)
• The prevention of transient thrombosis, strokes, heart attacks, pregnancy loss, and cancer.
In general, aspirin works well for dull, throbbing pain......however,
• It is ineffective for pain caused by most muscle cramps
• gastric distension
• acute skin irritation.
A combination of aspirin and caffeine, in general, affords greater pain relief than aspirin alone. Effervescent aspirin alleviates pain much faster than aspirin in tablets.
Aspirin does not ease pain during cycling exercise, while caffeine, surprisingly, was very effective. Similarly, aspirin, codeine or paracetamol have been shown to be not better than a placebo for muscle soreness after exercise.
Aspirin is a first-line drug in the treatment of migraine, bringing relief in just over half of the cases. Similarly to all other medications for migraine, it is recommended to take aspirin at the first signs of a headache.
Aspirin alleviates pain in about three-quarters of patients with recurring episodes of tension headaches. The addition of caffeine in a dose of to aspirin increases the ability to relive pain of a headache. There is some evidence low-dose aspirin has benefit for reducing the occurrence of migraines in susceptible individuals.
Prevention of heart attacks and strokes
The medical profession suggests that low doses of aspirin are indicated for the secondary prevention of strokes and heart attacks. For both males and females diagnosed with cardiovascular disease, aspirin reduces the chance of a heart attack and strokes by about a fifth.
Coronary and carotid arteries, bypasses and stents
The coronary arteries supply blood to the heart. Aspirin is recommended for one to six months after placement of stents in the coronary arteries and for years after a coronary artery bypass graft.
The carotid arteries supply blood to the brain. Patients with mild artery narrowing benefit from aspirin. After surgery of the lower legs using artificial grafts, aspirin is used to keep the grafts open.
Aspirin also helps with:
• sore throat pain
• fever joint pain of acute rheumatic fever – here it can respond extremely well, often within three days, to high doses of aspirin.
Along with rheumatic fever, Kawasaki disease (An acute disease of young children characterized by a rash and swollen lymph nodes and fever) remains one of the few indications for aspirin use in children, although even this use has been questioned by some.
Taking aspirin before air travel in cramped conditions has been suggested to decrease the risk of deep-vein thrombosis The reason for taking aspirin is the long period of sitting without exercise, not air travel itself.
Aspirin has been theorized to reduce cataract formation in diabetic patients. The role of aspirin in reducing the incidence of many forms of cancer has also been widely studied.
In another 2009 article published by the Journal of the American Medical Association, men and women who regularly took aspirin after colorectal (Relating to or affecting the colon and the rectum) cancer diagnosis were found to have lower risks of overall and colorectal cancer death compared to patients not using aspirin.
A 2010 article in the Journal of Clinical Oncology has suggested aspirin may reduce the risk of death from breast cancer. While the information has been well-circulated by the media, official health bodies and medical groups have expressed concern over the touting of aspirin as a "miracle drug".
A 2010 study by Oxford University involving over 25000 patients showed taking a small (75 mg) daily dose of aspirin for between four and eight years substantially reduces death rates from a range of common cancers by at least a fifth and the reduction of risk continued for 20 years in both men and women.
For specific cancers the, reduction was:
• about 40% for bowel cancer
• 30% for lung cancer
• 10% for prostate cancer
• 60% for esophageal (The passage between the pharynx and the stomach) cancer
• Reductions in pancreas, stomach, brain, breast and ovarian cancers were difficult to quantify.
However, taking aspirin doubles the annual risk of major internal bleeding that normally has a very low incidence (about 1 in 1000) in middle age, but increased dramatically after 75 years old.
• Owing to its effect on the stomach lining, manufacturers recommend people with peptic ulcers, mild diabetes, or gastritis seek medical advice before using aspirin.
• Even if none of these conditions is present, there is still an increased risk of stomach bleeding when aspirin is taken with alcohol.
• Use of aspirin during dengue fever is not recommended owing to increased bleeding tendency.
• People with kidney disease, or gout should not take aspirin because it inhibits the kidneys' ability to excrete uric acid, and thus may exacerbate these conditions.
• Aspirin should not be given to children or adolescents to control cold or influenza symptoms, as this has been linked with Reye's syndrome. (Disorder or disease of the brain following acute viral infections (especially influenza or chicken pox) in young children; characterized by fever, vomiting, disorientation, coma, and fatty infiltration of the liver)
Aspirin use has been shown to increase the risk of gastrointestinal bleeding. Although some enteric coated formulations of aspirin are advertised as being "gentle to the stomach", in one study enteric coating did not seem to reduce this risk. Combining aspirin with other NSAIDs (An anti-inflammatory drug that does not contain steroids) has also been shown to further increase this risk.
In addition to enteric coating, "buffering" is the other main method companies have used to try to mitigate the problem of gastrointestinal bleeding. Buffering agents are intended to work by preventing the aspirin from concentrating in the walls of the stomach, although the benefits of buffered aspirin are disputed.
Almost any buffering agent used in antacids can be used. One example is a product called Bufferin. Taking it with vitamin C is a more recently investigated method of protecting the stomach lining. According to research done at a German university, taking equal doses of vitamin C and aspirin decreases the amount of stomach damage that occurs compared to taking aspirin alone. Large doses of some types of aspirin, have been proposed to cause tinnitus.
Hives and swelling
For a small number of people, taking aspirin can result in symptoms that resemble an allergic reaction, including hives, swelling and headache. The reaction is caused by an inability to assimilate even small amounts of aspirin, resulting in an overdose.
Aspirin can induce swelling of skin tissues in some people. It can also cause prolonged bleeding after operations for up to 10 days. In one study, 30 of 6499 elective surgical patients required reoperations to control bleeding.
Aspirin overdose can be acute or chronic. In acute poisoning, a single large dose is taken; in chronic poisoning, higher than normal doses are taken over a period of time. Acute overdose has a mortality rate of 2%. Chronic overdose is more commonly lethal, with a high mortality rate. Chronic overdose may be especially severe in children
There have been some recent cases, as yet unsubstantiated by me personally, that aspirin ingestion has lead to blurred vision.
Aspirin is known to interact with other drugs, and alcohol also increases the gastrointestinal bleeding associated with these types of drugs.
Formulations containing high concentrations of aspirin often smell like vinegar because aspirin can decompose in moist conditions, yielding, inter alia, and acetic acid – i.e. vinegar.
When high doses of aspirin are given, it may actually cause fever. Owing to the issue of solubility, aspirin is absorbed much more slowly during overdose, and can continue to rise for up to 24 hours after ingestion.
Plant extracts, such as the use of willow bark of which salicylic acid was the active ingredient, has been known to help alleviate headaches, pains and fevers since antiquity. The father of modern medicine, Hippocrates, who lived sometime between 460 BC and 377 BC, left historical records describing the use of powder made from the bark and leaves of the willow tree to help these symptoms.
The lesson to be learned from this?
Although aspirin can be highly beneficial, and indeed effective in a wide range of human maladies, it is a good idea to make oneself fully aware of all the possible consequences of this seemingly innocuous substance. Most of all, the warning should be, although aspirin is very useful, and often necessary, one must not get into the habit of taking a few of these pills to put yourself on an artificial “high” – the consequences can often lead to an unexpected result.
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