I've had two colonoscopies - both taken on a full coumadin dose with my INR around 3.0. My internist, cardiologist and gastroenterologist both recommended I remain on the Coumadin for the procedure with the understanding that if a polyp were found, I would need to come off the Coumadin, go on Heparin and have the polyp removed in a 2nd procedure. There was no problem with either of the two colonoscopies.
Of course, as luck would have it, the first procedure located a polyp that required removal and biopsy so a 2nd procedure was performed 4 days later while off Coumadin. My followup colonoscopy 2 years later was done on Coumadin as will my next one.
None of my doctors will use Lovenox for artificial valves so your choices are procedure on Coumadin or on Heparin. I would never, never, never, come off the Coumadin and allow the INR to drop without a Heparin backup. Not worth the stroke risk.
Many gastroenterologists will not do a colonoscopy on a patient who is still taking Coumadin. I'd find one who would or go on Heparin for the procedure before I let my INR drop to the danger level.
