Low-Dose Aspirin Induced Gastric Ulcer in a Patient With TIA: A Clinical Caution for Aspirin Therapy Without Gastroprotection.

Balancing the cerebrovascular benefits of low-dose aspirin (LDA) with its significant gastrointestinal (GI) bleeding risk is a critical challenge in secondary stroke prevention. We describe a cautionary case of a 60-year-old male who, 6 months after starting LDA for a transient ischemic attack (TIA), presented with a life-threatening upper GI bleed. The patient had not been prescribed a prophylactic proton pump inhibitor (PPI). Investigations revealed a hemoglobin of 9.6 g/dL and multiple gastric ulcers on endoscopy, with negative testing for Helicobacter pylori. This case of a preventable, severe adverse event serves as a stark reminder that guideline-recommended gastroprotection is not optional but essential. Systematic risk assessment and PPI co-prescription in at-risk individuals are imperative for the safe and effective use of long-term antiplatelet therapy.