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Anticoagulants and Therapeutic Endoscopy

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Diagnostic and Therapeutic Procedures in Gastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Anticoagulants are very widely prescribed for patients at risk of thromboembolic disease and stroke and for those with mechanical heart valves. Warfarin and heparin have been the mainstays of treatment for many years, but more recently, a new class of anticoagulants has been introduced: direct oral anticoagulants (DOACs). DOACs have advantages compared to warfarin but pose particular challenges to therapeutic endoscopy as the level of anticoagulation cannot be simply measured by standard techniques, and there are no simple reversal measures in the event of hemorrhage. There is also an increased risk of spontaneous gastrointestinal hemorrhage compared to warfarin for some of these drugs. Many of the recommendations in international guidelines for management of endoscopy patients on anticoagulants have been made on limited evidence; this will be discussed critically in this review.

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Authors and Affiliations

  1. Endoscopy and Bowel Cancer Screening, New Cross Hospital, Wolverhampton, WV10 0QP, UK

    Andrew M. Veitch

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  1. Andrew M. Veitch
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Correspondence to Andrew M. Veitch .

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Editors and Affiliations

  1. Advanced Endoscopy, Digestive Health Center, Section of Gastroenterology & Hepatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA

    Subbaramiah Sridhar

  2. Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, Connecticut, USA

    George Y. Wu

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Veitch, A.M. (2018). Anticoagulants and Therapeutic Endoscopy. In: Sridhar, S., Wu, G. (eds) Diagnostic and Therapeutic Procedures in Gastroenterology. Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-62993-3_9

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  • DOI: https://doi.org/10.1007/978-3-319-62993-3_9

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