Endoscopy and warfarin

[PatWalsh010]

Good morning everybody - I had endoscopy last week and the doc wants to do another in a month to take biopsy. I have to stop warfarin for a week beforehand. Of course I will follow doctors orders but i am already anxious, concerned I’ll bring on a stroke because I am in permanent AF (living with it very well). Anyone been in similar situation? I will be at INR clinic next week and mention it to the girls. Just seems a long time to be without protection. Annoying thing is he said he would have done it last week only warfarin …..I did ring beforehand and was told low risk procedure so no need to stop warfarin grr. 🙄 thank you Patxx

[10gingercats]

I have had 3 endoscopies in as many years. Never stoped Warfarin which I was taking at the time. Now take Apixaban. Nobody mentioned stopping the Warfarin. All went well, No problems.

[PatWalsh010 in reply to 10gingercats]

Thank you. Did you have biopsy at the same time? I have a healing ulcer 🤷‍♀️ . Doc doesn’t seem too concerned, just wants to take biopsy from it to be on the safe side. As you know, not the most pleasant of experiences and frustrating to think it could have been done by now. I imagine it’s just a little snip, the biggest worry is to be unprotected for so long. I seem to remember in the past having a gynae procedure and I just had to skip one dose and doc was happy to proceed once INR was in range. Thanks for getting back. Patxx

[10gingercats in reply to PatWalsh010]

I had a biopsy on two occasions.

[BobD Volunteer]

That is odd as I have had several endoscopies including biopsies also prostate biopsies and minor surgey and never stopped warfarin so long a INR under 3. I guess different doctors have different ideas.

[PatWalsh010]

It looks like it’s up to the individual consultant then. Thanks very much for your responses. Patxx

[Newgran]

I had a colonoscopy only last week and I had to stop Warfarin 5 days before, though I restarted on the evening of the procedure. They did remove 2 polyps- which are now off for analysis- so obviously it was a precaution in case of excessive bleeding. When we have more than one thing wrong with us, the doctors have a balancing act! Hope everything works out OK for you.

[Hammerboy]

Hi , I had my endoscopy yesterday and was advised to not take my Edoxaban on the day of the procedure and restart today ?

[Drounding]

I'm on Edoxaban and was told the same when I had my endoscopy. I think it's in case of any complications during the procedure such as an accidental tear etc. Extremely rare I expect but it's a matter of weighing up risks I presume.

[Thomas45]

I had two colonoscopies two years ago. The first was diagnostic and I didn't stop taking Warfarin. The 2nd was to remove the 4 polyps found during the first. I have asymptomatic permanent AF. I was off Warfarin for 5 days, started again on the evening of the 2nd procedure. Just as an aside I chose not to be sedated and watched both procedures which went without incident.

[irene75359]

I had to stop warfarin and later Apixaban for procedures for biopsies. After a lot of telephone calls I eventually was prescribed bridging both times, but even the bridging had to be stopped for a couple of days around the procedures. I was most uneasy, but in the event I was fine. My sympathy though, it is worrying thinking about the 'what ifs'.

[PatWalsh010 in reply to irene75359]

Hi Irene - what is bridging. Patxx

[irene75359 in reply to PatWalsh010]

It is a short acting anti-coagulant. So if you bleed, you are less at risk (apparently!) but by no means am I an expert!

[PatWalsh010 in reply to irene75359]

Sorry to keep on at you Irene! Who decides you need that? Do you approach your gp, INR clinic or the surgeon who will be performing the procedure? Xxxx

[irene75359 in reply to PatWalsh010]

Don't worry about asking me, I am pleased if I can be of help! Certainly when I have had a procedure that required me to come off anti-coagulants, bridging hasn't been offered but I had read here on the forum of others who had asked. So I also asked for bridging whilst having a colonoscopy and two sigmoidoscopies. It isn't total protection as even with the short-acting anti-coagulant I had to stop the day prior to the procedures. I would contact the department that is doing your procedure and tell them your concerns. They may well brush them aside, they did mine, but I insisted and eventually I was given injections to self-administer (don't worry about that, it is easy and doesn't really hurt). Best of luck, and if I can help with anything else, just ask.

[PatWalsh010 in reply to irene75359]

Thank you 😘 - I can relax for now then. When I get the appointment I’ll get onto it. I can have a chat with the INR clinic too this week. My INR has been lovely and steady for ages, such a shame to have to rock the boat. Night xx

[Arthursullivan]

I am about to have a minor procedure on my vocal cords and the laryngologist wanted an assurance from someone else that it was safe for me to come off the Rivaroxaban anticoagulant. Of course no-one will say this. The period one is off apixaban or Rivaroxaban is 2-3 days lower than for warfarin which needs bridging therapy.

[Mildhypochondriac]

Beware of warfarin: it depletes vitamin K and may thus cause osteoporosis, apparently especially in men. Newer anti-coagulants such as apixaban do not need monitoring as warfarin does.

[PatWalsh010 in reply to Mildhypochondriac]

Hi everybody - thank you so much for all your input. I will chat to the nurses in clinic on Wednesday. The surgeon said he wanted to do it in 4 weeks (3 weeks now) but I’ll be surprised if I hear back so soon. There’s a backlog with everything so what he would like and what the admin side can manage to arrange could be very different time wise. Thank you all again.PatxxPs mildhypochondriac - I hope/trust I have the osteoporosis worry covered with my HRT 😀 and sensible diet but thanks for the info. Also, so far I’ve managed ok with warfarin - plenty of travelling and minor procedures over the years - this is the first time it’s been a problem. Patxx