What common over-the-counter medication can cause gastrointestinal bleeding when taken in excess?

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that is well-recognized for its ability to inhibit the cyclooxygenase (COX) enzymes, leading to decreased production of prostaglandins. Prostaglandins play a crucial role in maintaining the protective mucosal lining of the gastrointestinal (GI) tract. When aspirin is taken in excess, it can disrupt this protective barrier, resulting in increased gastric acid secretion and reduced bicarbonate secretion, which contributes to mucosal damage and can ultimately lead to gastrointestinal bleeding.

This risk is particularly significant with chronic use or high doses of aspirin, where the cumulative effects can lead to gastritis, ulcers, or erosions in the stomach or intestines, all of which can manifest as GI bleeding. Awareness of this potential side effect is critical for patients who may be using aspirin for pain relief or cardiovascular protection, as they need to balance the benefits with the risks associated with excessive dosage.

In contrast, while ibuprofen can also cause gastrointestinal bleeding due to its similar mechanism as an NSAID, it is commonly viewed as having a slightly lower risk profile in this regard compared to aspirin. Acetaminophen, on the other hand, has a different mechanism of action and does