Blood Thinners and Colonoscopy

[hhardt]

My brother-in-law is on ameroderone (sp) and coumidin and has just had the colonoscopy. 2 days later he started bleeding during the night and did not recognize the trouble he was in. Went to the ER Saturday AM (next day) and almost was lost. He has had several unts of blood, lots of other additives (ie potassium) and is finally stable enough today (Monday) to move to progressive care. They will go back in tomorrow to see what ------.

Before the test, he and the doctor discussed the drug situation, risks, etc. He was on the thinner because of a stroke condition. They decided together to not stop the thinner first. They found 6 minor polyps and one large polyp. He removed the 6 but left the large one for later due to the blood thinning medication. Apparently the removal of the 6 was sufficient to cause the excessive bleeding.

Thus - WARNING TO ALL ON BLOOD THINNERS. The issue of bleeding is not a joke or minor concern. As he found out, this can be serious and can lead to potentially death as nearly happened to him, and he is not out of danger. Everyone on a blood thinner MUST take the danger warnings serious. You are still your best doc and must watch what happens to you.

 

[bvdr]

Thanks for the reminder. My gastroenterologist had me come off coumadin because she knew a biopsy would have to be taken during my colonoscopy. I was on Lovenox except for about a 24 hour period. When I had an EGD earlier this year I did not have to come off my coumadin but was told if a biopsy or anything similar was needed that it would have to be done on another exam. I'm questioning the judgement of his doctor under the circumstances. If he had to go back in later for the big one then why take any polyps out at all during that colonoscopy?

Intestinal bleeding is serious and should not be taken lightly but an incapacitating stoke is even more so. I hope your brother-in-law recovers completely.

 

[geebee]

Sorry to hear about your brother in law. One of the things that has been discussed here is, if you do not go off coumadin for a colonoscopy, the doctor cannot remove any polyps. If he finds polyps, he will need to go back in and remove them at a later date when you are on bridge therapy.

I think most of us understand that but it is always helpful to be reminded.

Glad things turned out OK and I will pray the same for the polyps.

 

[Guest]

Six polyps removed from someone who was fully anticoagulated should be malpractice. A biopsy and maybe one (at most two) polyps removed are usually OK while fully anticoagulated.

There is nothing that required that doctor to do so much cutting while the person was anticoagulated. It would be interesting to ask the doctor the thought process that led to this fiasco.

I think what happened is exactly what could have been predicted.

When a colonoscopy on a fully anticoagulated person turns up something like this, the doctor is supposed to stop the colonosopy and have the patient prepare for a second one that will include stopping warfarin so the polyps may be safely removed.

It is possible to bleed to death while on warfarin but hopefully it will not be caused by an incompetent doctor.

 

[catwoman]

Hhardt:
I agree with Al's comments.

My gastroenterologist has said for me to (1) be on bridge therapy for a colonoscopy, during which he would remove any polyps, or (2) be fully anticoagulated, in which case if he found polyps, he would schedule a second colonoscopy (for a polypectomy) with me on bridge therapy.
He will not do a colonoscopy on anyone with a mechanical heart valve while NOT anticoagulated or not on bridge therapy. I didn't ask him about people who are on warfarin for other situations.

 

[Barry]

What Allodwick said. I had a colonoscopy and stayed on Warfarin with no problem. But if the doc had commenced cutting on me without doing bridging therapy first I would have been more than just a little annoyed.