Article Text


PTH-039 Should Anticoagulants be Stopped Before Diagnostic Colonoscopy?
  1. P G Vaughan-Shaw1,
  2. P Rai1,
  3. A Goodman1,
  4. M Aung1
  1. 1Department of Colorectal Surgey, Cheltenham General Hospital, Cheltenham, UK


Introduction With increasing age and polypharmacy, an increasing proportion of patients undergoing diagnostic colonoscopy take anticoagulant medication. Under UK guidelines anticoagulants are continued for diagnostic colonoscopy and which may necessitate a second colonoscopy for ‘high risk’ procedures after stopping anti-coagulants. This may increase endoscopy waiting times and subject often frail patients to a second invasive procedure. This study aims to identify the incidence of and indication for repeat colonoscopy.

Methods All colonoscopies performed over a 3 year period were studied. Any patients that underwent 2 colonoscopies within a 12-month period were included. Data on colonoscopy indication and outcome were collected.

Results 5747 colonoscopies were performed over the study period. Of these, 193 colonoscopies were repeats performed within 12 months. Incomplete colonoscopy (n = 54) due to poor bowel preparation (n = 45) was the commonest indication for a repeated procedure. Requirement for endoscopic mucosal resection (EMR) or polypectomy indicated a repeat colonoscopy in 48 cases. Patients requiring EMR on warfarin (n = 12) or clopidigrel (n = 2), accounted for 7% of all repeated colonoscopies with a median delay repeat colonoscopy of 37 days. There was no morbidity associated with repeated colonoscopy in this series.

Conclusion Repeated colonoscopy due to previous anti-coagulation accounts for a small proportion (7%) of repeated procedures and an insignificant proportion (0.2%) of all colonoscopies performed. Cessation of anti-colagulation for diagnostic colonoscopy would not result in a significant reduction in endoscopy workload but subject patients to an unnecessary risk of thromboembolic disease.

Disclosure of Interest None Declared.

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