Colonoscopy and warfarin

[Marty]

An article from that great source of anticoagulation research,McMaster University, Hamilton Ontario appeared in April 28, 2003 Archives of Internal Medicine entitled Perioperative Management of Patients Receiving Oral Anticoagulants.
The conclusion was
" Most patients can undergo dental procedures, arthrocentesis,
cataract surgery, and DIAGNOSTIC ENDOSCOPY without alteration of their regimen." 0% {0 of 111} of their endoscopy patients with or without biopsy had complications.
In a follow up Dr. Ansell the Boston guru doubts that any US gastroenterologists will change their recommendations despite the fact that it is in line with the latest pronouncement of the
American Society for GI Endoscopy. Inertia and fear of lawsuits probably.

 

[ccrawford]

Hi Marty - Question : Without getting too deep into the subject, is an endoscopy the same as a colonoscopy ? It was my impression that a colonoscopy was a more extensive examination and one that my require different anticoagulation protocol. --But I've been wrong before. Chris

 

[Missy]

I am interested in this one!!! I was just thinking about posting to find out the protocol for a colonoscopy. I am thinking that I need to get it done. Was told to do it last year after my brother had polyps removed. I will be looking and waiting to see what I can learn.
Thanks
Missy

 

[ALCapshaw2]

Thanks for that informative piece of information Marty.

I was a little confused about the comment in regard to Diagnostic Endoscopy though. I've had many Endoscopy's to inspect my Esophagus due to GERD. Is the term Endoscopy general in nature, i.e. can it also be used to refer (interchagably) to Colonoscopy?

'AL'

 

[Gisele]

They are different

They are different

A colonoscopy is normally done in the hospital and the patient is given medication to relax the patient (I think I had vercid and demerol) through my IV. The doctor is then able to go in deeper throughout the large intestine.

A sigmoidoscopy (?) is done in the physician's office and the bottom section of the large intestine is examined. The patient is not given any medication to relax.

I had to go off my coumadin for the procedure and use Lovenox. I was given the option by my doctor if I didn't want to stop coumadin I could still have the colonoscopy done but if they found something I would have to go back again at a later date when I was off my Coumadin. I chose to stop my Coumadin as there was no way I was going to do that prep again

Al, you are correct about endoscopy. That is when the physician examines the esophagus.

 

[Nancy]

Looks like endoscopy can have many meanings, including colonoscopy.

http://www.nlm.nih.gov/medlineplus/ency/article/003338.htm

 

[fyrfytr]

Hey Marty,
Thanks for the information. This is something we don't think about. At least I didn't.
Dave

Keep your fires small!
___________________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical
Heart Center of the Rockies

 

[Marty]

Endoscopy, Colonoscopy

Endoscopy, Colonoscopy

Endoscopy is a generic term that covers looking in any oriface. However the profession sometimes uses upper endoscopyfor the upper GI tract though terms such as esophogoscopy and gastroscopy are more specific. Colonoscopy of course means just that..scoping out the colon (includes rectum and sigmoid).
Sigmoidoscopy which your PCP may do as part of a physical exam often goes up no more than 8 or 10 inches.

 

[Gail in Ca]

I will be waiting for the non invasive colonoscopy. No way would I do the other one!
Gail

 

[ccrawford]

Gail - They do have what is called a virtual colonoscopy, but I don't know the details. Actually, a colonoscopy isn't that bad because you are usually asleep during the actual procedure. The worst part is drinking all that d____ pinapple flavored stuff beforehand to clean you out, etc, etc, etc. If you have to do one of these, make sure you have some interesting magazines in the bathroom, you'll be there awhile. Chris

 

[DickV]

Like Gisele, I had the option but opted to stay on Coumadin and had the procedure done with no complications. I even had a wisdom tooth pulled while on coumadin. The dentist packed and stitched it and also did not have any problems.

My cardiologist is against going off coumadin except for really major stuff and I am ok with that, so far at least.

 

[Marty]

$2700! Wow!

$2700! Wow!

I swear everything is bigger and better in Texas. My group in DC only charges $1500 fo virtual colonoscopy. The pictures are looking better and better. I think I will go that route.

 

[ccrawford]

Janie - thanks for the clarification. That was certainly a Texas sized story. If anyone says your full of hot air, I'll verify that at least your were at one time. Chris.

 

[ShezaGirlie]

Ok Chris guy!

I'll get you....I'm thinking and that can be dangerous...

By the way -- where is that avatar you've been promisin' us?

 

[ccrawford]

Hi Janie - You gals sure do have long memories. They say that if a guy has the last word in an argument, its really the start of a whole new argument. We all know what the last word he had was anyhoo --"YES DEAR" You know I wouldn't do a thing to elaborate on your message. Just an empty threat!! I did get to go to my grandson's state track meet and managed to swing by my favorite merchant and got a good deal on a case of Black Opal. Re the avatar -- hmm, I gotta get moving on setting up the digital camera, figuring out how to do a minimal picture, then send to buddy Ross for inclusion. Maybe when that case of Black Opal is gone ???? Chris

 

[DuchessBear]

I also opted to stay on Coumadin when I had my colonoscopy. If you are in a low risk category, that's probably the safest route. Save the more drastic lovenox/heparin option for when you know you really need it.

The main thing I want to mention here is that there is now a better prep method available. I did not have to drink the nasty stuff -- just took some pills (visicol). And the effects of the pills weren't as "dramatic" as others have described with the liquid method.

 

[Marty]

Interesting anecdote

Interesting anecdote

Thanks for your input Duchess Bear. Anecdotes like this are important in changing physician practise and are to be encouraged. Could you send me a private e-mail and let me know who did your colonoscopy? I am in a position to refer them additional warfarin patients.

 

[cookie]

I am scheduled to have a colonoscopy in Sept and was told by gastro doc that he would do procedure while on coumadin but he wanted me to be aware of possible bruising and if anything was found, the procedure would have to be done again off coumadin with a bridge therapy. So I opted for the bridge therapy with Lovanox. I'm not crazy about giving myself shots but it beats the alternative which is a week or more in the hospital on an IV for a 15 min procedure. No thank you.