Susie I am go to go in range and anticoagulated. No stopping Coumadin. Now if something is found and has to be removed, I'll have to go through this a second time, be admitted to the hospital and placed on a Heparin drip while Coumadin levels diminish and come back up. Not something I want to do, so I'm hoping nothing is found to warrant a second round.
As far as the ASGE guidelines go, they state it's not necessary to remove a patient for a routine screening colonoscopy. Well, not in those exact words, but print this out and if there is an arguement, you have your weapon ready.
http://www.asge.org/nspages/practice/patientcare/anticoagulation.cfm
Low risk is what I'm doing. If polyps are found, then it will become high risk and another course of action need be taken.
Recommendations
Low-risk procedures: No adjustments in anticoagulation need be made irrespective of the underlying condition. However, elective procedures should be avoided when the level of anticoagulation is above the therapeutic range.
High-risk procedures in patients with low-risk conditions: Warfarin therapy should be discontinued 3 to 5 days before the scheduled procedure. The decision to obtain a preprocedure prothrombin time should be individualized.
High risk procedures in patients with high risk conditions: Warfarin therapy should be discontinued 3 to 5 days before the procedure. The decision to administer intravenous heparin once the INR falls below the therapeutic level should be individualized. Preliminary experience suggests there may be a role for monitored reduction in the INR without the use of heparin. Heparin, if used, should be discontinued 4 to 6 hours before the scheduled procedure and may be resumed 2 to 6 hours after the procedure. Warfarin therapy may generally be resumed the night of the procedure.
