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British Heart Foundation
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Colonoscopy and heart surgery

Hello, my husband is having a colonoscopy tomorrow. We have read various things that say you need to let the team know if you are going to have heart surgery. Strangely our own hospital says nothing about this

The colonoscopy is being done at one hospital and the valve replacement is being done at another next week. We are both feeling a bit confused now. Does anyone know if it is wise to have a colonoscopy so near to having heart surgery?

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Sadly departments within hospitals and different hospitals are often very bad at communicating with each other. You need to raise this with the colonoscopy team first thing in the morning or when you arrive. Also call the cardiac team first thing - the cardiac nurse may be able to advise. There are so many different heart conditions I doubt anyone here can really advise. What may be safe with one condition may be risky with another.

As a general rule anybody with multiple conditions should raise the issue with the appropriate teams as early as possible. It is seriously late in the day to be raising this. The people treating your husband would know better than any internet "expert". I have seen total carp on line related to diabetes!

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As long as you have raised your fears with both teams and are sure that they have taken them on board, it will be fine. Senior hospital staff are far too cautious to go ahead with risky procedures and will only proceed if they feel comfortable about it.

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Thanks for your replies. We called the cardiac unit and they said it is fine to go ahead.

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From my experience it is essential to DEMAND prophylactic antibiotics.

A colonoscopy is a good way to introduce nasty bugs to the body, particularly if as happened to me, they remove polyps (wee lumps or growths) which need to be biopsied if they find any, to discover if they are malignant or non-malignant.

The situation as I understand it, is a bit complicated, but until about 5 years ago, NICE (the National Institute of Clinical Excellence) which decides NHS policy on which drugs to use etc, recommended that anyone with a dodgy heart or history of endocarditis (infection in or around the heart) should have antibiotics before ANY invasive procedure (which might cause bleeding), that included any dental work other than a check-up. Then in an attempt to reduce the over-use of antibiotics they dropped this recommendation. Data is being collected on how many extra cases of endocarditis have resulted from the change of policy. Meanwhile many cardiologists in this country and also those in Europe insist on the prophylactic antibiotics.

I had endocarditis in 2012, a mitral valve replacement in 2016 and a colonoscopy last summer without the prophylactic, followed by endocarditis in 2017 . As a result I spent 5 1/2 weeks in hospital on 8 doses of intravenous antibiotics a day, 1 1/2 weeks as an outpatient on 1 IV a day, followed by 6 weeks of tablets 3 times a day at home. That was the start of October 2017 until into new year 2018. That's how scared they were that he bug I picked up would settle on my new heart valve which would then need replacing again!

I'm not going to the dentist until I get my letter from my present cardiologist asking for me to have antibiotics. Sorry if this sounds scary, but yes make sure all your husband's doctors know about everything.

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Thank you for your reply. Well now we have other worries. My husband had the colonoscopy and he has been found to have bowel cancer. Until the CT scan next Monday we won't know how invasive this is. My husband is due to have his valve replacement next , Friday, but now both teams have to decide which surgery should be done first. We are still in a bit of shock.

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So sorry to hear that. Lots of love to you both x

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Thank you x

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