Gastrointestinal Haemorrhage, Gastric Ulcer and Aspirin

Summary In 1,634 admissions for acute gastroduodenal haemorrhage, the diagnosis was chronic peptic ulcer in two thirds, and “acute lesion” in one quarter. The age incidence of female gastric ulcer was bimodal, with peaks in the fifth and seventh decades. This was in conformity with previous observations of a younger group of female gastric ulcer patients in this community. A high proportion of this younger group took aspirin preparations regularly. 66% of the ulcer and "acute lesion" groups had taken aspirin before haemorrhage. However, in nearly 50% this was part of a regular habit of aspirin taking and in only 17% was it an isolated event. More of the “acute lesion” group took isolated aspirin before bleeding than the ulcer groups but the difference was not significant. The significance of isolated aspirin taking in the aetiology of acute gastroduodenal haemorrhage has been exaggerated by a failure to distinguish it from regular aspirin intake. In both males and females there was a significant association of gastric ulcer bleeding and regular aspirin consumption compared with the duodenal ulcer and “acute lesion” groups. Isolated aspirin taking occurred in those with pre‐existing ulcer as well as those with “acute lesions”.