Aspirin and macular degeneration

[SezMe]

Enteric coated aspirin solves the gastric irritation better than taking it with food if that option is available.

I take 1 regular aspirin a day. How would I identify an enteric pill?

 

[Frank Merton]

I take 1 regular aspirin a day. How would I identify an enteric pill?

My understanding is that an enteric pill is one coated in such a way as to delay the release of the aspirin, thereby reducing the harshness on the stomach lining.

I would not advise this, but I will be interested in seeing other views. There was a bit of a stir a little while ago to the effect that people were seeing a phenomenon called "aspirin resistance," where the typical baby aspirin does was not enough.

It appears that this was in people using enteric pills.

I am of the opinion, and I don't want to start an argument here about it, so I welcome contrary views, that this method of avoiding harm to the stomach lining is ineffective anyway -- that aspirin does what it does to the stomach lining in other ways than direct irritation.

So I adopted the policy of always taking aspirin with food. Another poster, probably accurately, dismissed this. I find, myself, that I have less reflux (in fact none) if I take aspirin with food, but this is probably unrelated to any stomach harm.

So we remain at having to stay at the low dose. Fortunately the evidence seems to be that, at least for cardiac protection, this is enough, and that taking more does no good. Unfortunately, the evidence regarding aspirin's ability to prevent and even fight cancers is more dose dependent.

One thing one might do is watch one's stool for black stool, indicating the presence of digested blood, which can be coming from the stomach lining. Any such bleeding (unless of course it is from a known source such as nose bleeds) should be checked anyway.

 

[Frank Merton]

More overgeneralizing and in this case with a whole lot of crap.

I guess I do a lot of that. Let me defend this a little, as it is something I notice we do -- we draw conclusions from biased data. In this case the doctor's data is his clinical experience, and here he only sees the cases where aspirin has caused problems, so he draws the conclusion that aspirin is bad. (Of course he doesn't frame it so unprofessionally, but that remains his subconscious belief).

Second, how many physicians are there in the world? And you think they are all the same, practicing in some narrow fields, none interested in the least in prevention? That is a naive belief.

Well, yes, if that were my view it would indeed be naive. Regardless, I don't see my doctors' rolls as doing anything for me under most circumstances -- only in those cases where I have a serious illness. To be sure they are interested in prevention, and public health doctors have that as their duty, but the personal physician can only rarely make suggestions to patients. They have not the time and we cannot afford the expense that would be required to do otherwise.

American doctors disturbed? Puhleese. We've been treating hep B in the US with antivirals for well over a decade.

The only thing I can figure is that you refer to the treatment of acute cases. The attitude about my chronic case has always been one of my having a sonogram once a year and otherwise not doing anything, as my liver tests were normal, the virus was present in numbers below some threshold that was never made clear, I don't drink or smoke, and am therefore not a candidate for anti-virals.

This had always bothered me, as we all know that the presence of that virus increases the chances of several liver diseases, including cancer. I felt if it was treatable it should be treated, provided the treatment meets a few other standards such as safety, efficacy and reasonable cost -- which it does.

The Vietnamese had no hesitation, and put me on anti-virals plus a medicine popular here for liver insult called "Nissel" (Biphenyl Dimethyl Dicarboxilate) that apparently has never been tested on humans, at least to the FDA's standards. Three months later follow-up showed no detectable virus, but they insisted I stay on these for at least two years.

I am persuaded that in some ways Vietnamese medicine is better than US medicine in that they are legally safe from plaintiff attorneys, and hence can do what they genuinely think best, rather than what they can defend doing under legal attack.

Aspirin does not cause your blood vessels to burst. Aspirin affects platelet function. If you experience trauma (accident, surgical, or spontaneous) then normal clotting is affected by aspirin.

Noted. Here again, though, I see reason for keeping low blood pressure, so that one doesn't have spontaneous trauma in the brain's blood vessels.

 

[casebro]

I've also heard that enteric coatings may not break down at all.

Hey, if coatings and slow release formulas are totally dependable, why can't I take one-a-day BP meds? Those formulas seem to be used in optional pills, not the live-or-death stuff.

So I take 1/2 of a regular aspirin every day, with my morning coffee with milk and molasses. Plus a handful of supplements in gel caps. I seem to tolerate it fine.

 

[Skeptic Ginger]

I take 1 regular aspirin a day. How would I identify an enteric pill?

They are coated and the label says "enteric coated".

Is there a reason you don't take low dose? (80mg or "baby aspirin" vs 325mg)

 

[Skeptic Ginger]

WebMD's general advice on low dose aspirin is accurate as far as I can see.

Mayo Clinic's advice is a tad more detailed.

They both agree on dose, paraphrasing, "low dose is as effective, however a few doctors prescribe the 325Mg dose."

From the MayoClinic site:

Should you take a coated aspirin?

Enteric-coated aspirin is designed to pass through your stomach and not disintegrate until it reaches your small intestine. It's gentler on the stomach and may be appropriate for some people who take a daily aspirin, especially in those with a history of gastritis or ulcers. However, some researchers think there's no evidence that taking an enteric-coated aspirin decreases your chance of developing gastrointestinal bleeding. Talk to your doctor if you're concerned about ways to decrease your bleeding risk.

If you want to know if the brand you use will dissolve, put it in water with some baking soda and salt. Those are the conditions the coating is supposed to dissolve. Casebro is right in that some cheaper generic brands were of concern when it didn't look like they actually released their drug in the gut. However, there were also misconceptions when people didn't see their meds dissolve in water. There was a reason: Coated aspirin didn't dissolve in water

Tap water could be slightly acidic and contains few ions

 

[SezMe]

Is there a reason you don't take low dose? (80mg or "baby aspirin" vs 325mg)

I used to take the low dose. Then I had a TIA. Subsequently both the neurologist and my GP independently said to bump it up to a regular one.

 

[Skeptic Ginger]

...
The only thing I can figure is that you refer to the treatment of acute cases. The attitude about my chronic case has always been one of my having a sonogram once a year and otherwise not doing anything, as my liver tests were normal, the virus was present in numbers below some threshold that was never made clear, I don't drink or smoke, and am therefore not a candidate for anti-virals.

It sounds like you know a couple doctors and concluded the millions of doctors around the globe are all the same.

As for treating HepB, in the US the standard treatment is at least a course of antivirals to try to eliminate viremia (virus in the blood). Finding existing liver damage or low grade hepatitis is not necessary.

I'm not aware blood viral titers for hepB are done to decide treatment course but it's possible other countries have such guidelines. We do viral load determinations with HIV, and serotypes with hepC to guide treatment decisions.

...I am persuaded that in some ways Vietnamese medicine is better than US medicine in that they are legally safe from plaintiff attorneys, and hence can do what they genuinely think best, rather than what they can defend doing under legal attack. ...

Got any data to back that up?

 

[Skeptic Ginger]

I used to take the low dose. Then I had a TIA. Subsequently both the neurologist and my GP independently said to bump it up to a regular one.

Sounds reasonable.

 

[Frank Merton]

It sounds like you know a couple doctors and concluded the millions of doctors around the globe are all the same.

I'm not really basing this view on doctors I know, but on the logic of it. However, it would help explain why so many doctors remain so opposed to widespread aspirin use in spite of the evidence, and why there is such an emphasis on sticking to the low doses.

Got any data to back that up?

Of course not; if I did I would have stated it as a fact: I only stated it as an opinion. Think about it though -- Americans spend a much larger proportion of their GNP on health care than anyone else, but the outcomes are not measurably better. Why? I think the legal system is a large part of that.

There is a conception about the dynastic cycle of China. The new dynasty comes in, fresh, wiping out all the bureaucrats and accountants and lawyers. The nation and the people prosper, the economy grows, and so on. Over the generations an encrustation of new rules with bureaucrats to manage them and so on develops, and after a century or so the dynasty is corrupt and rigid.

America appears in many ways to be in decline, for much the same reason.

 

[SezMe]

I think the legal system is a large part of that.

You might want to give that a rethought to that opinion by reading this and this and this and this to get started.

 

[Frank Merton]

You might want to give that a rethought to that opinion by reading this and this and this and this to get started.

Anyone can find web sites that support their particular views on anything, and I have found that my going and reading them is largely futile, so I don't. I'm interested in exchanges of thoughts with real people, not citation battles.

Besides, if we are to discuss this, it should be in a different thread.

 

[SezMe]

That you're unwilling to look at cites is telling but you're right that it is a derail. I'll drop it.