Colonoscopy: Had frightening visit to A... - Hughes Syndrome -...

Hughes Syndrome - APS Support

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Had frightening visit to A+E last weekend after passing lots of blood.lots blood tests and examination and thought was piles.saw my own gp yesterday and he said if I wished he would sent me for colonoscopy to be sure.Thing is now I am afraid with being on warfarin that I will bleed alot more than when I had this procedure years ago and not on warfarin.friend said they will ask me not to take warfarin for days before but then I will be at risk.does anyone know what hospital does in this case in UK.can't wait til the letter as I am worrying myself sick

18 Replies

When I had colonoscopy yeard agi, they gradually decreased warfarin but put me on heperin.

The day of colonoscopy didnt take clexane until after, then continued untol INR was back up.

You need to talk about your worries with your GP.

Good luck

Fra22-57 in reply to HollyHeski

Thanks for reply Holly. My gp just remarked"oh your on warfarin are you" don't know my records like RA consultant so maybe will have to ring specialist nurse there


You should ask them to prescribe a full, therapeutic dose of Fragmin, usually calculated on your body weight in accordance with the manufacturer's advice leaflet. When I was on Warfarin I used to start Fragmin and stop Warfarin a week before the procedure and the restart Warfarin soon after the procedure but keep injecting Fragmin too, until my INR is back on target. This method is sometimes called 'bridging'.


Thanks Dave. That sounds reassuring

I have been successfully 'bridged' a few times for various procedures and operations. Just as others have said. If you are under the care of a consultant they can advise you of a plan. I am due to have surgery soon and have asked my APS consultant to write to me to say what their procedure is. Then I will get in touch with the hospital to tell them what it is and take it from there.

Fra22-57 in reply to panda60

Brilliant.that sounds good. Thank-you very much


Hi you need to have a chat with them about bridging this will put your mind at rest. MaryF

Fra22-57 in reply to MaryF

Thank-you Mary

I'm due to have a colonoscopy on the 11th March and I'm seeing the Haematologist next Tuesday to discuss whether to stop the Rivaroxoaban/Aspirin and go to Clexane for a few days around the time. The guy doing the scope saw me in hospital last year (Oh! I remember you-you have the difficult diagnosis - maybe a bad thing when he only saw me briefly 3 months ago!;)) and so is aware of bleeding issues. I'm going away for a couple of weeks and will be back just in time for the prep (Ugggh) and get done.

Fra22-57 in reply to Ozchick

Good info.let me know how you get on Ozchick

I agree about bridging with heparin.

Have had this applied a number of times in the last five or so years when I have had various 'oscopies' (;-0)

At least on the last one I was able to deal at home myself, whereas the first they had me in for a week to do it. Pretty well understood now so long as you say why you are on warfarin and that our group cannot just some off warfarin.

Fra22-57 in reply to tim47

Thanks Tim.valuable info

tim47 in reply to tim47

For the sake of clarity (difficult when there is a bit of brain fog going on) I should not have said we cannot come off warfarin, rather I should have said we cannot come off anticoagulation of one sort or other but for the minimal time necessary for the procedure to take place, and recovery depending on whats been done, and that should probably be thought of in terms of hours and not the usual five days.

On one occasion, after a failed endoscopy where I was not receptive to the sedative, I injected heparin within half an hour of them giving up. On another, after a colonscopy in which polpys were removed, I injected hepin early next morning, as well as restarting warfarin.

Apologies for any confusion

Fra22-57 in reply to tim47

That's OK've been very helpful thanks

I echo all above. You have to contact the day surgery unit (or whichever department is doing the scope) and nudge them that you're on anti-coagulation. Ask them to confirm you will be bridged for the procedure. Unfortunately I did have one procedure booked that didn't take this into account (at early diagnosis stage for me) and the warfarin is not easily counteracted, so it was cancelled.

In an emergency, if they realise you're on a particular anti-coagulation, then they can reverse some of them with specific injections - I believe warfarin is counteracted by one particular drug/injection in emergency situations. It's why I wear a med bracelet, as hospitals won't always read your notes and pick up, even if you've been "with" them for some time. Let's face it, even if with "your" specialist, they probably have several hundred patients in their specific care and deal with hundreds more on referral...

Many many thanks.I will do that

Hi, not from UK, but you can ask Placidway for help. They have packages all around the world and you can contact them just to ask for it. I know someone who had treatment abroad and the services were great. Anyway, you can have a look on their site or ask them directly: +1.303.500.3821

New update on visit to consultant at hospital. Colonoscopy ordered and will be within 6weeks.Said he like to keep me on warfarin throughout it.If any polyps etc will not remove but wait another time for colonoscopy.

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