Has anyone had a gastroscopy/ endoscopy and had to stop anti-coagulation ( or not stop) and been given any info about stroke risk?

Be grateful if anyone would share their experience- endoscopy is likely to stimulate the vagus nerve so I am concerned about being off anti coag while having the procedure- but of course bleeding risk is there too.

Any feedback welcome!!

20 Replies

  • Hello there RosyG

    I've just had a colonoscopy & had to leave off anti coags and it was ok. As I was told should a stroke happen then it would be sorted as blood could be thinned and clot dispersed. I was worried about it... like anyone would be .... but it went ahead with no problems. Will think of you


  • Thank you Nikki- did they give details about how they would do that? I winder if they would give heparin if AF started

  • I was told that drugs to disperse clots would be given; afraid I didn't ask for more details. I don't take warfarin am using one of the newer drugs Rivaroxyban . Heparin is still used as far as I know but others will be available . My heart now is in permanent AF ( has been for over 2 years) ...and I still came through ok .Don't worry too much ... it'll be fine . I stopped taking the anti coags for 4 days before procedure.

    Take care


  • Thank you Nikki !

  • Hello Rosemary ... I had a gastroscopy almost 2 years ago. I seem to remember that I had to phone the dept. re my warfarin beforehand with INR details . I dont think I had to stop taking it. I have on my records that I was teste d at the hospital that morning ( INR 2.1 ) Procedure nothing to worry about really as you are given relaxant.


  • That seems better Sandra- not stopping you, but seems they do stop NOACS- I will ask what they do if one goes into AF

  • Hi Rosemary,

    As you know I am in AF 24/7.

    I had a gastroscopy 10 weeks after being diagnosed with AF but before my appointment at the warfarin clinic. Therefore bleeding wasn't discussed, but neither was stroke risk. I remember the leaflet saying warfarin users would need to stop for 3 - 5 days before procedure.

    When I had my sialendoscopy my INR had to be under 2 .

    Take care.

    Best wishes


  • I am booked for an EUS (endoscopic ultrasound) on 15th. Have to stop Warfarin 5 days beforehand but have self injected substitute meds before and after. Can't remember what it is called. Previously had bad bleed requiring hospitalisation and transfusion after an endoscopy and biopsy so am happy to be careful this time.

  • that's helpful to know thank you Judy as it's tempting to ask to stay on apixaban but bad bleeding would be risky Thank you

  • Hi Rosemary. I had colonoscopy a few months ago and stayed on warfarin.

    Maybe ask about going on warfarin just for this period??


  • thanks Marie- not sure about swopping but it's a good suggestion

  • Hello rosyG.

    I had an Endoscopy in January this year and was concerned about the Warfarin and the procedure. I was told to try and present myself nearer to 2.0 than 3.0 and on the day I think my INR was 2.1. The Endoscopy Team was excellent and I can honestly say that the experience was considerably less unpleasant than I anticipated even though I chose not to be sedated ( a last minute decision ). A rescope may be necessary in the future and I really hope the the hospital guidelines have not changed!

    Best wishes.

  • Thank you mrtee very helpful

  • Hi,

    I have had two endoscopies now and each time they have just taken blood test to make sure that the inr is not too high. Both of these have been via the mouth.

    Good luck and try not to worry.

    Best wishes,


  • Thank you Pat - it seems as if it is better to be on warfarin when having endoscopy!!

  • Take care.


  • Something that was said a couple of times during the AFA Patients Day in Birmingham yesterday is that different hospitals have different policies as to when to stop and when to restart medicines and some don't stop at all (this applies not just to NOACs but also Warfarin and other medicines).

  • yes I've been looking at different Trust's online guidance and some allow Apixaban to continue- More Trusts seem to stop it for a day for Endoscopies

  • Never heard of withdraiwing Warfarin or Apixaban etc. before an endoscopy and I did not think to ask about it.I had one to look at the back of my heart before an op. and another to check the inside of my stomach.....these were in different years and in diff. dep.ts. of the same hospital. Nobody mentioned bleeding...and I did not bleed.Neither was I taken off Warfarin 5 years ago before a hole in the heart 'op'.

  • I have gained an impression (and I may be wrong) is that many heart consultants are quite happy to have a person still on anticoagulation whereas many other consultants or doctors do not. I would suspect that a lot of this is due to the fact that hear consultants are generally very much more knowledgeable about anticoagulation, etc. Also I suspect that another big factor is that in reality there has been a lot of new knowledge gained in the last 15 years since catheter ablations started and therefore most consultants and doctors did not cover it in their training. After all some medics don't know that aspirin is no longer to be used as an anticoagulant!!!