Help!

I have taken a cancellation appointment in General Surgery for colon problems and have been sent a letter today (appointment is tomorrow ) asking me to take a laxative as I will be having a sigmoidoscopy. I havnt had a letter telling me to advise them that Im on an anticoagulant but the nhs website clearly states that I should. Ive rung the hospital and unbelievably there is no one there that can advise me. My G.P. is unwilling to advise me and is trying to ring for advice but I havnt heard back from her yet.

If there is no definitive answer I am just going to turn up anyway but that means I will have to take the laxative and drive for an hour and wait for who knows how long and possibly be sent home with nothing done! Has anyone had this proceedure on apixaban? I am high risk as I have had 3 TIAs so dont want to come off if I can help it. X

11 Replies

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  • stockport.nhs.uk/documents/...

    I found this from Stockport, dedeottie - they want all AC's stopped. I hope you can get advice before you undertake so much travel and stress. xx

  • dedeottie,try the NICE website,there are guidelines on Apixaban and stopping for surgery/ investigations.

  • Hello Dedeottie, I've had a colonoscopy (full bowel) and a sigmoidoscopy (part bowel). With the colonoscopy I was taken off Rivaroxiban for 3 days before. When I had the sigmoidoscopy the cardiologist had taken me off them because of another condition, but I was asked if I was still taking them before the procedure. I'm wondering if because you took a cancellation, it's been rushed through and it's been overlooked. In her position your GP must be in touch with someone at the Hospital to get advice, it's too important for her to ignore, and I hope she contacts you soon. If my memory serves me right, you don't take as much laxative for a sigmoidoscopy and the bowel is empty before you leave home, so don't worry about that, but you don't need all this stress, I hope it's all sorted for you before morning.

  • Hi and thank you. My G.P. said she couldnt advise me and she tried the hospital and had the same response as I did so she said the ball is in my court!! I looked up the NICE guidelines which state that for endoscopy type procedures, missing one dose of apixaban would do but they couldnt remove any polyps unless i had been off apixaban for 24 hours. I am going to take the laxative and go for the appointment but because I am high risk for a stroke i dont want to take it upon myself to miss even one dose without a medical person telling me it is ok. This is the third time I have taken a cancellation with bad results as the normal procedures get overlooked. Next time I am going to say no. I must admit to feeling that medics in general are scared stiff of dealing with anticoagulated patients and it makes me feel very alone.Thanks for your help i really appreciate it.

    Can you tell me roughly how long I should allow for needing the loo before setting off ? X

  • Hello again dedeottie, I didn't need the loo again to empty my bowel after I left the house, I worried about this myself. When you come out your stomach will be full of wind and that was the most embarrassing part for me as I visited my Brother in Law who was in Hospital at the time and I was sat at the side of his bed unable to stop myself making rude noises. I wish you luck for tomorrow and hope all will be well.

  • I am not a medic but just a thought. Anticoagulant is absorbed into your bloodstream. The laxative acts in the colon. Therefore perhaps if you are taking your blood clotting meds in the evening, and your laxative prep in the morning - they may well not conflict.

  • Thanks everyone for your comments. In the end I have decided to go for my appointment and to delay taking the apixaban until I can speak directly to a doctor. I phoned this morning and still no one who can advise me although it was only 8.30. I am going armed with the NICE guidelines. I feel like a warrior! Hey ho thank goodness for this forum for people to moan to. X

  • All is done! The doctor didnt seem worried whether I had missed a dose of apixaban or not, he was more interested to know why I was on apixaban as opposed to warfarin( i didnt think He had long enough to listen to THAT story).

    He couldnt see anythibg so now I have to have an internal scan to show the rest of the colon and other organs. Before long every bit of me will have been photographed. I have been wondering if it is my vagal nerve that has been irritated by the last "nearly ablation" and that somehow I have become more sensitive to abdominal pain but he didnt look like the sort that would be receptive to that so I kept my mouth shut.

    Anyway, stress over for now. Thanks my friends. X

  • Glad everything went well- only just seen your post - very tricky to come off apixaban with your history

  • Glad everything went well. I was due for a colonoscopy but as soon as I mention discharging some black blood from my rectum that was changed to a CT scan. That highlighed a 2cm polyp in my sigmoid colon and so I had a sigmoidoscopy. I was taken off warfarin 5 days before and was kept off for 5 days after. I felt very unprotected. The polypectomy went very well. The polyp was benign.

  • Im glad all was well. Im guessing that when I spend hours on the loo for the CT scan my medication wont be affected because it absorbes into the blood stream rather than pass through the colon. Im hoping so anyway I dont fancy being in A.F. for the whole thing!

    It is good to hear from others that have undergone this torture! X