Warfarin and stomach ulcer

[Ylmom]

I have been on Warfarin for 3 years. This past year I feel like I always have a stomach ulcer. Has anyone else had this feeling with Warfarin? If so, what can been done? I try to watch what i eat and drink but it doesn’t seem to matter anymore. I wish I could switch to a less harsh blood thinner. Anyone out there have luck switching off Warfarin to something else?

[KellyInTexas Administrator]

I’ve not had those problems on warfarin-

I’ve switched from warfarin to other anticoagulants for other reasons ( re clotting, highly unstable inr, etc) , but clotted immediately on other anticoagulant other than warfarin right away.

Are you on omeprizole? ( proton pump inhibitor? Nexium for example? Prilosec? )

These can cause more problems than the solve for a vast many patients.

Talk to your GP about an urgent referral to a gastroenterologist if you are on such a medication without it being on advice of a gastroenterologist.

Otherwise your hematologist should be consulted either way to weigh in immediately.

You do need a gastroenterologist if you don’t already have one.

The problem could be any number of problems - or even a combo of problems. The solution could be actually simple.

It may not be the warfarin.

The answer to other anticoagulant therapy is yes, maybe!

As always, it depends on the patient.

Many here are on injectable heparin ( LMWH) and do well.

You must have a hematologist who understands APS. It must be give at 1 mg per kg of body weight for us - every 12 hours.

Usually jr aspirin is also given.

[Ylmom]

Thanks Kelly for your response. I am not on any gastro meds. I try to take only what I absolutely have to or do natural as much as possible. I am concerned they will want to do a scope and I have had not procedures like a scope or colonoscopy sense getting on Warfarin. Have you?

When they were first trying to DX me, the put me on jr aspirin and it tore my stomach up.

[lupus-support1 Administrator in reply to Ylmom]

If you suspect you have an ulcer, you must see your doctor asap else this can lead to a bleed.

I take, as Kelly suggested, omeprazole daily. No one wants to take medication, but if your stomach or oesophagus is inflamed it can lead to a bleed.

You are likely to need to see a gastroenterologist and have a procedure to see what’s going on. It is minor. A day Case taking a few minutes. You will be sedated and not know what’s going on. You will have a nice sleep, wake up, be given a drink, wait for an hour and go home. They will tell you the result.

Please get this sorted out lest you have a bleed, which can be dangerous as you are on warfarin!

With good wishes,

Ros

[KellyInTexas Administrator in reply to Ylmom]

I have not had a procedure yet on warfarin.

I suspect you would be switched to LMWH ( lovenox = enoxaparin in the USA= Clexane in UK) .

This way you can be brought down with anticoag quickly for scope and brought back up quick after.

It has a very quick 1/2 life- that med is in and out of system lickity- split!

( that’s why it’s injected every 12 hours. )

Yes, as Ros states, you might do well with omeprezole.

Bottom line- data is needed ASAP.

My gastro would recommend old fashioned Gaviscon in the mean time while you wait… maybe elevate yourself from the waist up just a little - 10 degree incline while you sleep to prevent acid from refluxing up during the night.

Call right away.

[MaryF Administrator]

Hi, this question would be a good one for your GP and consultant/specialist for Hughes Syndrome/APS. If your stomach is causing you grief like that, you need some investigations to see what is going on. Be aware that a lot of stomach protecting medication can block your absorption of B12 so make sure that you are thoroughly investigated. Your stomach could be protesting for any manner of reasons, in my case it was gluten! MaryF