Analgesic intake and the risk of acute upper gastrointestinal bleeding.

A comparison of aspirin and acetaminophen consumption in 346 matched pairs of patients with hematemesis and melena and general population control subjects has shown associations between intake of both drugs and bleeding. The association for acetaminophen was weaker and was not detectable for habitual intake, whereas the association for aspirin was detectable for recent and habitual intake. Taken overall, the results suggest, by reference to acetaminophen, that patients frequently take analgesic drugs because of the symptoms of bleeding, and such intake is not causal of bleeding. Investigators who fail to employ appropriate control subjects to take account of this point exaggerate the possible risks of aspirin consumption.