Which of the following is also a side effect of aspirin?

• A. Tinnitus
• B. GI upset
• C. Bronchospasm
• D. GI bleeding

Answer: (D)

Aspirin disrupts protective mechanisms in the stomach and slows blood clotting, so it can cause significant GI bleeding. By inhibiting COX-1, it reduces protective gastric prostaglandins, making the stomach lining more vulnerable to irritation and ulceration. At the same time, aspirin irreversibly inhibits platelet COX-1, leading to prolonged bleeding time. The combination of mucosal injury plus impaired hemostasis makes GI bleeding a well-established and clinically important adverse effect.

Tinnitus is linked to salicylate toxicity at higher doses, not a common side effect at standard dosing. Bronchospasm occurs mainly in aspirin-exacerbated respiratory disease in susceptible individuals. GI upset is common but typically milder than bleeding; GI bleeding is the more serious and characteristic adverse event highlighted here.