Abstract
Aspirin causes an erosive gastritis in some but not all patients. Increased acid and pepsin secretion is associated with family inheritance, the blood group and the ABH salivary secretion, and predisposes to bleeding after aspirin. In 321 cases, hereditary effects are minor in comparison with strong extrinsic influences including excessive emotion, fatigue, anxiety, infection, alcohol, irregular meals and heavy smoking. When these destructive influences are conjoined, intensification of 1 or more may precipitate a hemorrhagic "explosion" without the triggering influence of salicylates.