Comparison of the effects of regular and enteric-coated aspirin on gastroduodenal mucosa of man.

To determine whether the topical or systemic effects of aspirin are of greater importance in the production of gastroduodenal mucosal damage, the effects of regular and enteric-coated aspirin were compared in 9 healthy volunteers in a 2-week crossover endoscopic study. All subjects developed multiple gastric erosions while taking regular aspirin; 2 subjects developed one gastric erosion each while taking enteric-coated aspirin. 5 subjects developed duodenal erosions while taking regular aspirin, whereas none developed an erosion while taking enteric-coated aspirin. Mean fasting salicylate levels were similar in the two groups. It is concluded that regular aspirin causes a greater amount of gastroduodenal mucosal damage than does enteric-coated aspirin despite similar serum-salicylate levels. This suggests that the topical effects of aspirin are of greater importance than the systemic effects in the production of gastroduodenal mucosal damage in healthy subjects.