Colonoscopy reqd

[KevinW]

I need to have this done in 2 weeks due to a positive reading on my annual bowel scan, they detected blood in my stool.
This is my first bowel scan since going on warfarin in January

Anyway I have be 'scoped' so theyve told me to stop warfarin 3 days before the proceedure

Does anyone know, will this bring my INR down to zero on the day of the colonoscopy or will it still be 1 or something (my usual INR is 2.7, my ideal range is between 2 & 3 according to my cardiologist and my surgeon)

I obviously worried about the results of the scope and about having a low INR for 3 days, so double worry for me.

 

[dick0236]

Anyway I have be 'scoped' so theyve told me to stop warfarin 3 days before the proceedure

Does anyone know, will this bring my INR down to zero on the day of the colonoscopy or will it still be 1 or something (my usual INR is 2.7, my ideal range is between 2 & 3 according to my cardiologist and my surgeon)

.

The normal INR of a person NOT on warfarin is 1, not 0. Many on this forum report that they have had colonscopies done without stopping warfarin with no problems. I have never had a colonoscopy but I would be very reluctant to go off warfarin for several days without bridging and I would certainly get my Cardio involved before the test.

 

[KevinW]

My cardiologist has sanctioned stopping it for 3 days, he says the risk is minimal

You can have a colonoscopy whilst on warfarin, but if they find any polyps they cannot be removed and you would have to go through the whole thing again to have them removed (the probable reason for blood being detected in my stool is a bleeding polyp Im told)
Its a very good idea to get these removed as they are usually what turn cancerous and you could end up with Bowel cancer, so by lowering my INR for the test I can have any polyps removed then & there.

 

[ski girl]

My understanding of INR is that it's the ratio of how long your blood takes to clot, versus how long it *should* take. So 1.0 is the normal, and 2.7 means it takes 2.7 times as long to clot as someone with an INR of 1.0.

Others who know more should feel free to correct me!

 

[pellicle]

My cardiologist has sanctioned stopping it for 3 days, he says the risk is minimal

Fwiw my inr plummets within 2 days of being off warfarin. My surgeon didn't even ask me to go off before doing a debridement operation.

 

[kimcdougc]

My dr told me before my Colonoscopy, they would take me off of Coumadin for 5 days and bridge me with (forgive me but I forget the meds they use) shots and then have my colonoscopy, remove any polyps. They would then restart my Coumadin. The inr clinic can help you with any information you would need to do before your colonoscopy. They are very educated about it, at least they are here.

 

[Protimenow]

According to one paper that I saw a few months ago, the risk of stroke is greatest in people whose INR is below 2.0 for one week or more. Apparently, being below range for 3 or 4 (or probably even five or six days) isn't considerable. Being off Warfarin, then bridging, sounds like a pretty safe approach. (It may even be safe to be off for five days, have the colonoscopy/polypectomy, then restart Warfarin once the procedure is finished).

I wonder if there have been studies comparing the risk of colon cancer in those taking warfarin to the risk of colon cancer in those who don't take warfarin.

 

[AgilityDog]

This is approximately what your INR clinic or doctor should tell you for bridging instructions:
Hold coumadin at least 3 days prior to surgery. Some do 5 days for major surgery, 3 for colonoscopy
Lovenox, or generic Enoxoparin sodium injection, at 1 mg/kg of body weight every 12 hours, beginning when INR drops below 2.0, and stopping approx 16 hours prior to surgery. (for ex. at 150 lbs, I take 68 mg).
After surgery, you start taking your warfarin that evening. After 2 days y)ou should be close to range, and at 3 days you should be back in range.

 

[Cooker]

I had one this year and was off for three days with no problem.. I was told that the aortic mechanical valve is less likely to have clotting problems than the mitral mechanical valve. In fact if I had had a mitral mechanical valve they would have wanted me to bridge. I stressed about it for nothing. All went well. I'm sure you will do fine and I hope the outcome of your colonoscopy is a-ok!

 

[KevinW]

I had one this year and was off for three days with no problem.. I was told that the aortic mechanical valve is less likely to have clotting problems than the mitral mechanical valve. In fact if I had had a mitral mechanical valve they would have wanted me to bridge. I stressed about it for nothing. All went well. I'm sure you will do fine and I hope the outcome of your colonoscopy is a-ok!

thanks Cooker

my cardio said bridging is not needed
I might have a glass of wine or three (good blood thinner )

 

[KevinW]

Just an update, I had my Cscope yesterday and all is fine, just some bleeding from internal haemorrhoids

Im back on my regular dose of warfarin now 4.5mg, according to the pathologists my INR wouldve reduced from 2,8 (my average) to about 1,8 ish due to my 3 day abstinence, so if anyone else needs a colonoscopy and has to stop warfarin for 3 days, dont panic !!