What is the effect of aspirin on the mucosal tissue of the stomach and the vocal fold? "John Messmer, M.D." <jjm23@p...> wrote:NSAID's work by inhibiting an enzyme, cycloxygenase (COX for short - it's also easier to say.) There are two forms (that we know of) of COX: COX-1 and COX-2. COX-1 is involved in the production of chemicals in platelets that make them stick together and a chemical in the stomach that protects it from its own acid (and some other things, but I don't want this to be a hematology lecture). COX-2 helps produce the chemicals that cause pain and inflammation.
The original bunch of NSAID's inhibited both COX's and thus were called nonselective COX inhibitors. They could cause bleeding and ulcers since platelets were inhibited and the stomach was not protected due to COX-1 being blocked while treating inflammation by blocking COX-2. (We are constantly having little hemorrhages and blood vessel leaks if we traumatize some area, but platelets plug the leaks very quickly so we mostly don't notice it. If we abuse our voices we can get microscopic hemorrhages that can be bigger if our platelets are inhibited.)
COX-2 selective NSAID's block MOSTLY COX-2. The effect on COX-1 is clinically irrelevant for the most part. Thus for all practical purposes, they should not cause bleeding. They will still protect one from inflammation so one might abuse one's voice and not realize it due to the reduced edema from the NSAID. To date I am not aware of any data on singers in particular however.
John
John Messmer, M.D. Assistant Professor, Family and Community Medicine Penn State Hershey Medical Center
> -----Original Message----- > From: Candace Magner [mailto:magner@l...] > Sent: Tuesday, November 05, 2002 12:34 PM > We have had some recent discussion about NSAIDs (ibuprofin, > aspirin, etc) and their effect on the mucosal tissues of > stomach and vocal folds. The newer meds for arthritis > [celecoxib (Celebrex), rofecoxib (Vioxx) and valdecoxib > (Bextra)] are of a slightly different formula (COX-2 > inhibitors) and are said to be less problematic.
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