Decisions about 81 Aspirin and Bleeding

Posted by woojr @woojr, Oct 2 3:47pm

73 year old male good body weight, eats pretty healthy. I've been on 81 mg baby aspirin since 2008 when I had a double bypass.

Two weeks ago had rectal bleeding (first time ever), Went to the ER and had CT with no masses or tumors. Then had an endoscopy showing mild gastritis. Colonoscopy showed diverticulosis and two polyps resected and sent for biopsy. There was no active bleeding anywhere. My Hemoglobin dropped below 8. I've looked at all sorts of information leading me how what I believe is, Aspirin the cause of the bleeding. My cardiologist just retired and my new cardiologist just a week ago postponed my yearly visit until next year. When I got home from my four day stay at the hospital I was very tired and after eating again, I have had no bleeding at all. I had stopped taking the 81mg Aspirin when the bleeding stopped two weeks ago today. For a few days after release from the hospital my right calf had some swelling and tenderness. This was not unusual, my right leg is often a bit swelled but never tender. The swelling subsided but I also experienced some shortness of breath and fatigue with minor exertion like taking trash out. This morning I was reading I shouldn't have stopped the Aspirin without seeing a medical professional. So I walked outside a bit and was feeling the light shortness of breath. I decided to cut the 81 Aspirin in half and I took it. Now it gets weird. My wife and get in the car, she's driving me to a different Dr's Appt. About half hour later and my chest feels better. I mean no tightness. A few hours later I walked some more and chest feels fine. Sometimes it's difficult to separate this tightness from shoulder pain (I need replacement there). So I'm seeing the family Doc next week. I feel the Aspirin is connected to symptoms like bleeding and possibly breathing. I've been taking it for 17 years and have terrible bruises for a long time. I also use Voltaren for my joint pain. Thank you for reading and comments.

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Janell, Volunteer Mentor | @jlharsh | Oct 4 1:21pm

Good call, @woojr to get back on your aspirin until you can visit with your family Doc next week. This whole thing has to be pretty scary for both you and your wife.

I am in the middle of a similar process, enough to know there can be several things impacted. I had an upper scope a few months ago that showed damage. GI was able to provide information about risk and recommended I find out if I need to continue baby aspirin that I have been taking since 2017. After hearing my cardiologist at the time had me start taking it he was on board that I continue. Currently, I am following my primary docs recommendation to take a PPI to protect my stomach from the aspirin, and consider famotidine if I have problems.

After I had the scope I started recognizing pulmonary symptoms we are troubleshooting as well. I am not sure what is happening, but I do know regular exercise is helping me minimize problems and to feel better.

I am interested to hear your family doc appointment goes next week. I hope you come back and provide an update.

You mention having a colonoscopy and may still waiting for biopsy results, but no active bleeding. Do they think doing an upper scope may help? I assume you haven’t had concerns when you last saw your cardiologist. Are you aware of having any pulmonary problems?

woojr | @woojr | Oct 6 3:52pm

In reply to @jlharsh "Good call, @woojr to get back on your aspirin until you can visit with your family..." + (show)

@jlharsh Sorry for the late reply. Also sorry to say I don't have a lot of confidence in my family doc. But that's what's available and she should have the results of the biopsies. This is Wednesday. They were from some locations upper GI and from the polyps they removed. So I had an endoscopy and colonoscopy after I had a CT scan. It's been two weeks and I'm feeling better and have no bleeding that I can see. I haven't done any vigorous stuff around the yard as that was what I was doing when the bleeding started. And yes I am taking baby aspirin but only one half a day. So everything is improving and I haven't had any heart symptoms. I will report back after my upcoming visit. Thanks for your note. Also, let me say I believe going to the ER with an issue like this since they've always gotten to the bottom of my symptoms. I arrived at the small town country hospital on Sunday afternoon and had the CT in less than an hour along with bloodwork. They set up the endoscopy Monday afternoon and had results which led to the colonoscopy on Wednesday and I left later that afternoon. They checked top to bottom about as quickly as they could. That prep took awhile. I've talked to several people my age and found many of them have experienced the same bleeding and had no active bleeding after the tests.
And the bruising on my arms is really bad. I can't believe it's okay to ignore it any longer. Your mention of famotidine is new to me, I'll look this up later tonight. Take care, thanks again.

woojr | @woojr | Oct 9 11:43am

I visited my primary care yesterday. This was a very informative visit. She had most of the hospital reports and like so many visits to the hospital we find out something we didn't know. From biopsies it was found I have H pylori bacterial infection of the stomach lining. I'm on three antibiotics for two weeks. She told me this was found early and could lead to cancer if left untreated. Wow. If we put off symptoms they don't cure themselves. I'm still waiting for the biopsy results from two polyps.
As for the 81 Aspirin, I'm off it until the stomach clears up. There was no positive connection between the Aspirin and stomach lining infection.

woojr | @woojr | Oct 9 12:53pm

One more thing. I'm learning about my hemoglobin. I've had many surgeries but never really paid attention to hemoglobin because I never lost much blood. I believe I can feel the drop, some fatigue that's new.

Janell, Volunteer Mentor | @jlharsh | Oct 15 8:15pm

@woojr
It sounds like a very good thing you visited your primary care, finding out about H pylori bacterial infection and starting treatment. I am hopeful with you that the infection clears up easily now that you are taking antibiotics and that biopsies of two polyps come back clear.

I want to introduce you to @cmx who may have information to share since experiencing chronic gastritis, ulcer pain and other symptoms that led to symptomatic iron deficiency anemia, all caused by H Pylori. Also, @amerc and @kathie1234 who have also commented about H.pylori.

You may have reviewed already, but I am adding a link to Mayo Clinic’s overviews you may want to take a look at:
- (H. pylori) overview: https://www.mayoclinic.org/diseases-conditions/h-pylori/symptoms-causes/syc-20356171
- low hemoglobin: https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360

How are you feeling now that you have been taking antibiotics for almost a week?
Did your primary doc tell you if H pylori has caused the complications you have been having?
When do you follow up with your doctor again?

woojr | @woojr | Oct 16 11:45am

Thanks for the links and I will be looking at them.

I've been feeling okay, no bleeding and regular BM's. I'm half way through the scripts.

My PCP didn't say anything about complications from H pylori but she was well versed in the plan she set up of the antibiotics. I also am taking Lansoprazole which seems to make my stomach very comfortable. I do have some hiccups occasionally which is unusual.

As far as symptoms that led me to the hospital, they cleared up before I had the tests. There was no bleeding by the time I left the hospital.

The doctor wants me to have stool sampling a week after I finish the scripts and see her a week later. I also spoke to the gastroenterologist I saw in the hospital. He is retiring in a few weeks and explained I would need to take a stronger antibiotic if the infection isn't cleared up.

I also had some confusion in the filling of the scripts. Apparently my doc has always done the scripts as a "package." The pharmacy wanted the scripts filled separately. FYI, I also had a tough time dealing with "WellCare" AI on a mail order script. I ended up having the PCP's nurse handle it. I'm not looking forward to AI.

Thanks again, I'll update when I get the results after I finish the meds.

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