Black stools and dizziness, what's going on? It turns out that it's caused by drugs such as aspirin. How to prevent and treat them?

Uncle Li, who turned 60 not long ago, took aspirin antiplatelet treatment for cardiovascular and cerebrovascular diseases for a long time last year. Recently, he developed black stools and bleeding gums, but he did not pay attention to it until he had bloody stools and dizziness, then he rushed to the hospital.

Dr. Chen Cheng from the Department of Cardiology at Hunan Provincial Second People's Hospital received Mr. Li and asked him in detail about his medical history, the course of his coronary heart disease, the time and dosage of aspirin he had taken, whether he had other diseases, and his recent diet and lifestyle habits. After a series of examinations, he confirmed that Mr. Li had gastrointestinal bleeding caused by taking aspirin.

After the doctor's careful treatment and Mr. Li's active cooperation, Mr. Li's gastrointestinal bleeding symptoms were gradually controlled. This situation is very common, so Dr. Chai Xiaoli, Director of the Department of Cardiology at the Second People's Hospital of Hunan Province, provides detailed guidance for everyone:

1. Aspirin and Coronary Heart Disease

Aspirin plays a vital role in the treatment of coronary heart disease. It can inhibit platelet aggregation and reduce the risk of thrombosis, thereby reducing the incidence of cardiovascular events such as myocardial infarction and stroke. For patients with coronary heart disease, long-term regular use of aspirin is one of the important measures to prevent the disease from worsening.

2. Causes of gastrointestinal bleeding caused by aspirin

While aspirin plays an anti-platelet aggregation role, it may also cause damage to the gastrointestinal mucosa. Its main mechanisms include: direct stimulation of the gastric mucosa, inhibition of the protective mechanism of the gastric mucosa; affecting the aggregation function of platelets, leading to an increased bleeding tendency. In addition, factors such as older age, a history of gastrointestinal ulcers, and taking other anticoagulants or non-steroidal anti-inflammatory drugs at the same time can also increase the risk of gastrointestinal bleeding.

Weighing the pros and cons

When patients with cardiovascular and cerebrovascular diseases experience aspirin-induced gastrointestinal bleeding, the severity and risk of the disease need to be considered comprehensively. On the one hand, if aspirin is stopped rashly, the risk of cardiovascular events may increase; on the other hand, continued gastrointestinal bleeding can also pose a serious threat to the patient's health.

When weighing the pros and cons, doctors usually make an assessment based on the patient's specific situation. If the gastrointestinal bleeding is mild, aspirin can be continued under close observation, and some measures to protect the digestive tract can be taken at the same time. For example, proton pump inhibitors such as omeprazole and lansoprazole are prescribed to patients to reduce gastric acid secretion and protect the gastric mucosa. At the same time, patients are advised to pay attention to their diet, avoid spicy and irritating foods, and maintain a regular diet.

If the bleeding is severe, you may need to temporarily stop taking aspirin and treat the gastrointestinal bleeding first. The doctor will give you hemostatic drugs, replenish blood volume, and other treatment measures, and re-evaluate whether you can continue to use aspirin after your condition stabilizes.

4. Correct way to take medicine

1. Pay attention to the dosage: Under the guidance of a doctor, choose the appropriate aspirin dosage. Generally speaking, low-dose aspirin (such as 75-100 mg/day) can play a role in cardiovascular protection while relatively reducing the risk of gastrointestinal bleeding.

2. Combination medication: For high-risk patients, the combined use of proton pump inhibitors (such as omeprazole, lansoprazole, etc.) can be considered to protect the gastric mucosa and reduce the occurrence of gastrointestinal bleeding.

3. Regular check-ups: Patients who take aspirin for a long time should undergo regular blood tests, stool occult blood tests, etc. to detect signs of gastrointestinal bleeding in a timely manner.

4. Pay attention to your diet: Avoid eating spicy and irritating foods to reduce irritation to the digestive tract mucosa. At the same time, maintain a regular diet and avoid overeating.

In short, when taking antiplatelet drugs such as aspirin, cardiovascular and cerebrovascular patients should pay close attention to their physical condition and seek medical attention in time if they experience abnormal symptoms such as stool color changes and gum bleeding. Under the guidance of a doctor, the correct method of taking the medicine should be adopted to ensure that cardiovascular and cerebrovascular events can be effectively prevented and adverse reactions such as gastrointestinal bleeding can be reduced.

Hunan Medical Chat Special Author: Feng Miaolin, Department of Cardiovascular Medicine, Hunan Second People's Hospital

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(Edited by Wx)