Chronic use of aspirin and alcohol may increase the risk of which complication?

• A. Decreased sodium
• B. Decreased salicylate level
• C. Increased risk of GI bleeding
• D. Decreased Prothrombin Time

Answer: (C)

Chronic use of aspirin with alcohol increases the risk of GI bleeding. Here’s why: aspirin (an NSAID) inhibits COX-1, which lowers protective prostaglandins in the gastric mucosa. Those prostaglandins normally help maintain the stomach’s protective lining by promoting mucus and bicarbonate production and keeping blood flow adequate. Alcohol directly irritates the stomach lining and can cause gastritis and ulcers. When both are used together, the mucosal defenses are weakened while irritation is increased, and aspirin’s antiplatelet effect further impairs clot formation if a bleed begins. So the combination most strongly raises the chance of gastrointestinal bleeding.

Other options don’t fit as well. Sodium levels aren’t specifically driven by this combination, salicylate levels would not decrease (they’d stay high or rise with continued use), and prothrombin time isn’t typically decreased by aspirin or alcohol in this context.