Endoscopy......

[chelb29]

Anyone who's had an endoscopy (Upper GI) is it ok to stay on your warfarin at your normal range? Do you need clexane instead? As a procedure rather then an operation I was unsure as to what you do in regards to your warfarin. Are there any huge risks? Thanks.

[ndstephens49]

Hi!

Had upper and lower GI scopes on April 7 this year. On April 3 took regular dose Coumadin. On April 4 took Lovenox in evening and every 12 hours till day before scopes. I set alarm on my phone so I wouldn't forget to take lovenox. I stopped lovenox 12 hours before scope time. My scopes were early in morning and I resumed lovenox about 10:30 am. I restarted Coumadin the night of April 7 but continued lovenox till my INR was in target range. Took about 3 days.

This is what my GI doctor wanted. Check with yours to see what he prefers.

Interestingly, my pacemaker doctor did NOT want me to totally stop anticoagulation for even 12 hours when he installed new pacemaker. He adjusted my Coumadin so that it was between 2.7 and 2.9 the day of the procedure. I can't believe he was able to figure how to do that, but he did.

Different doctors are comfortable with different things. BUT don't totally stop anticoagulation -- I had a doctors who scared me into stopping Coumadin 3 days before a procedure with NO BRIDGE and I ended up in a mess. This was a long time ago when I was stupid. I know better now.

Nancy

[HollyHeski Administrator]

It really depends on doctor/surgeons and what they are expecting to do, especially if they want to take biopsies. Most are unhappy to do anything with our INR so high, dont understand that this just makes us normal.

Prior to the procudure the doctors or endoscopy nurse will go through this with you - and yes will probably put you on a bridging plan.

[CormorantWatcher]

It depends on the doctor. I've had many. They never remember to ask if you're on it.

One time I forgot to ask and the Doc wasn't confortable due to the bleed risk and I had to wait until the end of the day and take an INR reading. Another time they bridged me down from warfarin with heparin.

Another doctor, when I asked about it, said the risk from bleeding, even with biopsies, was minimal and didn't need me to stop.

It's important to ask the doctor that will conduct (or be responsible for it if it's a registrar under a consultant) the procedure, as they will have their risk level and understand what their procedure means to them in conducting it.

But do ask - don't turn up to then be told you need to have a specific INR range or bridging plan before you arrive, as nobody wants to delay these things!

[orygun66]

Dr Schofield suggested perhaps I have a heparin drip until however many hours before scopes are done rather than bridging and stopping 12 hours the night before. I haven't gotten to that place yet because the first GI doctor ignored me so going to a different one.

[Julie_T]

Left my warfarin as usual, said bridging wasn't necessary (range 3.5-4.0).

One thing though, given a choice of local or anesthetic, I chose local as I wanted to leave immediately. Have to say it was very unpleasant and I will choose differently in future!

Good luck & best wishes

[lupus-support1 Administrator]

The doctor should have given you instructions regarding this prior to this procedure. If they have not, you need to contact them for advice.

An endoscopy is a procedure, but there is always a risk of bleeding.

You cannot and should not make this decision. If necessary, your GP needs to ask on your behalf. I am surprised that no one has given you this important information.

With good wishes,

Ros

[chelb29]

Thank you so much for all your responses. I have not actually seen the gastroenterologist yet, appointment is next week. Just wanted to be armed with the information before I went. Dr D'Cruz has asked for the referral due to my ongoing indigestion issues which he feels is not warfarin related, which I was previously told by the GP was!