Colonoscopy.

[kiki1952]

I have to have a colonoscopy and stop rivaroxaban,I was told to take the last one on a sunday and have the colonoscopy on the Wednesday. I had a TIA in Febuary when I also found out I had AF. I am now going into AF every 2 days and it lasts for 36 hours to a couple of days and I will be in AF and not be on the rivaroxaban, so this has got me worried and I am thinking of cancelling the colonoscopy. What would you advise?

[meadfoot]

Do you have a cardiologist or preferably an electrophysiologist. If so check with them regarding stopping the rivaoxaban to ensure you are clear about your safety. Best to get their advice for support and reassurance. Best wishes.

[kiki1952 in reply to meadfoot]

meadfoot.

Thank's

[Nanfranz]

I echo Meadfoot's advice, Kiki! It also seems to me that your cardiologist and the colonoscopy doctor need to discuss your case. Are you taking any medication to control the Afib? If not, please ask your cardiologist about the possibility. Keep us posted, please!

[kiki1952 in reply to Nanfranz]

I just take 5mg bisoprolol and 20mg Rivaroxaban.

[kiki1952 in reply to Nanfranz]

Thank's

[BobD Volunteer]

Do ask you cardiologist to speak to the surgeon who will do the colonoscopy. Realistically you only need to stop the day before and start again after it has been done I suspect but these drugs have only been around a few years and many surgeons are not up to speed yet.

[kiki1952 in reply to BobD]

Thank's

[Hidden]

Not having a colonoscopy could deny you an opportunity to better your state of health, so personally I would be keen to go ahead with it and not worry about not taking rivaroxaban for a short time.

You will find that lots of people have had to stop their anticoagulation for a procedure or operation and usually the discussion is about when to do so, not whether to do it or not. I don't think one is more at risk when AF is present and in fact over a few years of reading posts on the forum, I've noticed it is quite rare for anyone to report having a stroke.

I'd certainly try to be referred, as suggested above, to a cardiologist or an electrophysiologist but more to see if your AF can be better controlled than it is now.

[kiki1952 in reply to Hidden]

Thank's

[DGET1 in reply to Hidden]

Totally disagree with you Rellim2, of course you’re more at risk of stroke when AF is present, that’s why you take the anti coagulant. I actually had a TIA myself before my AF was diagnosed. So, I would be worried about stopping it to have Colonoscopy.

[kiki1952 in reply to DGET1]

Thank's.

[Hidden in reply to DGET1]

What I'm saying is that we are at risk all the time, not merely when AF occurs. In other words the cessation of AF does not mean the risk diminishes as clots that form during AF can linger. Concern was expressed about having AF over the absence of the anticoagulant.

There are two issues here and the other is stopping anticoagulation in order to have a procedure that has been deemed prudent. Should our reliance on the safety net of anticoagulation deny us opportunities to investigate other health issues? I agree that it is worrying to be very briefly without anticoagulation but less bad possibly than allowing a potential problem to progress undetected. Alternatively a colonoscopy may well rule out a problem and provide long term peace of mind.

[jennydog]

About a year ago I posted on here about the conflicting advice I had received from the surgeon and the pre-op nurse about stopping dabigatran prior to my discectomy. The nurse was actually giving warfarin advice. Your Cardiologist is the best person to advise. There is an appalling lack of knowledge about NOACs

[kiki1952 in reply to jennydog]

Thank's

[Hi-1964]

When i had same procedure my surgeon Said i didnt need to stop my Abixaban .

[kiki1952 in reply to Hi-1964]

Thank's.

[DGET1 in reply to Hi-1964]

I work in Endodscopy Dept in local hospital, and if your only having diagnostic procedure ( just having a look), you don’t need to stop anticoags, it if it’s therapeutic i.e. biopsies or polypectomy

then you don't need to stop them.

[DGET1 in reply to DGET1]

Sorry do need to stop them

[fairgo45]

I Had to come off warfarin to have a colonoscopy last year

It all went well and I was in permanent A/Fib the whole time

The colonoscopy is a life saver don't worry you will be ok the odds are in your favour

[kiki1952 in reply to fairgo45]

Thank's.

[Lovethatlast]

Talk to your doctor. After my colonoscophy I haven’t had an AF attack in several months. I think mine is Vagus nerve related. I have been very good about what and how I eat since then

[kiki1952 in reply to Lovethatlast]

Thank's.

[Lovethatlast in reply to Lovethatlast]

You are so blessed to have a doctor who will admit that it is Digestive track that triggers you AF. I knee that was triggering my AF, however, my cardiologist laughed and said it was just because I was getting old..had nothing to do with my gut! Thousands of young people have AF. I was very disappointed he was so unwilling to help me or refer me to someone who could help solve this gut rather than heart problem. Just handed me scrips and away he went. I have learned how to manage my trigger by myself. Like you I watch my eating habits and learn.

[afafriend1]

I have a colonoscopy every two years. Four years ago I was taken off Warfarin for five days prior to the procedure during which time I had a TIA as I also had several episodes of AF. Since then, when I come off Warfarin prior to the procedure I am on a bridging regime of daily Clexane injections which are easy to administer. I am astonished that such a measure is not standard practice in those who have AF and have also had a TIA.

[kiki1952 in reply to afafriend1]

Thank's.

[DGET1 in reply to afafriend1]

Totally agree

[kiki1952 in reply to DGET1]

Thank's.

[Lovethatlast in reply to afafriend1]

Probably more expensive. Insurance, Medicare and Medicaid are limited so much now on how much time and expense you are allowed for each patient.

[MazzyB]

I really would go ahead with it! Certain the doctors will know what’s best for you. Hope all goes well.

[kiki1952 in reply to MazzyB]

Thank's.

[Reb500]

I would look into the option of doing "Cologuard" instead which does not require the traditional prep (it is a noninvasive test). This is a a relatively new DNA test that finds the same number of cancers as a traditional colonoscopy and (in the US) is approved to replace the colonoscopy for screening in people with a regular risk of cancer. As part of the approval process, they conducted a study in which 10,000 people underwent both traditional colonoscopies as well as Cologuard and compared the rate of cancer and polyp detection with both methods. They found that Cologuard finds about the same number of cancers but It finds fewer of the pre-cancerous polyps (something like just 67%), so it has to be repeated every 3 years to catch those. The thing about Cologuard that appealed to me is that it is not invasive. It is a a stool test in which they look for cancerous cells so it requires absolutely no prep. I was very concerned that the prep for a colonoscopy would send me into AF so I started investigating non-invasive colon cancer screening methods and was very pleased when I found this.

[kiki1952 in reply to Reb500]

Thank's.

[Lovethatlast in reply to Reb500]

I would like to add... pre-cancer detection does save lives. Also, if you have family history or history of digestive problems. Probably a colonoscopy should be considered the best testing.

[BubblesL]

Did they say why you have to stop the rivaroxin? I wonder if they were afraid of it interacting with the meds they give to put you to sleep during the procedure. If that's the case then maybe you could talk to your doc about staying awake during the colonoscopy. I'm not a doctor, but I do know people who stay awake during the colonoscopy. I was told it feels uncomfortable but not awful.

[kiki1952 in reply to BubblesL]

Thank's

[cuore]

You say, "I am now going into AF every 2 days and it lasts for 36 hours to a couple of days ." When I reached a somewhat similar pattern, I went into persistent AF. Then I read somewhere that when one has such a pattern, one goes into persistent within a year. (I would have to go through all my notes to find the article.) I hope you are also addressing your AF with your EP.

[kiki1952 in reply to cuore]

Thank's.

[xanadu13]

I am not going to offer an opinion to you as all off our bodies are different including reactions to anesthesia, what is found in our colon, or the expertise of the doctor, anesthesiologist and their assistants.

That said, because of a family history of my maternal grandmother, my mother, and my sister, all now deceased, and all had colon cancer as complicating factors. Because of these factors, on my own, I've submitted annually, then bi-annual and now every three years to the unpleasant procedure and hey have found benign polyps on 3 separate occasions. This all began while I was in my early 60s and I'm age 81 now. Iff I'm here in 2019 I'll undergo, as I calculate, my 9th procedure after stopping what ever anticoagulant I was or am, on at the time. After warfarin, Pradaxa and now taking Eliquis while experiencing unchained AF 24/7/365 during the last 3 or 4 procedures, I assure you if our maker keeps me on this earth till 2019 I'll stop my thinner and undergo that unpleasant procedure again. AF is certainly a biggy, a stroke occurring during a 3 or 4 day period is worrisome off medication is an unknown, but pooping in a bag with daily irrigation when cancer is not detected early is a certainty that my wonderful Mom underwent daily over her last 24 years which included 2 colostomies and finally an Ileostomy.

May God Bless you now and during the New Year.

[kiki1952 in reply to xanadu13]

Thank's.

[MtLSteven]

If you are going to have a Colonoscopy I suggest sedation. Midazolam and Fentanyl. Midazolam is a sedation and an amnesiac. Fentanyl a short acting analgesic. Both wear off in hours. So no side effects but no driving.

[kiki1952 in reply to MtLSteven]

Thank's.