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We find no fault with the conclusions reached by Dr Hanauer and, in fact, fully support his closing statement that "aspirin remains the drug of choice unless clearly not tolerated."
However, we feel that Dr Hanauer missed the major point of our paper, namely, that a scientific methodology is available that can be employed in a feasible manner to test the "short-term risk of erosive gastritis" in patients who receive drugs that contribute to this risk. No data were presented on long-term risks of these drugs. As indicated by Dr Hanauer, the true frequency of a major gastrointestinal bleeding episode, in contrast to the smaller amounts of bleeding usually seen in erosive gastritis, remains to be determined by clinical experience. For the short term, we suggest that objective data as illustrated by our report best assess this facet of drug action.
Loebl DH, Craig RM, Culic DD, Falk J, Schmid FR, Ridolfo AS. Gastrointestinal Blood Loss-Reply. JAMA. 1977;238(9):937. doi:10.1001/jama.1977.03280100021007
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