Minireviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2016; 8(17): 584-590
Published online Sep 16, 2016. doi: 10.4253/wjge.v8.i17.584
Blood thinners and gastrointestinal endoscopy
Monjur Ahmed
Monjur Ahmed, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Ahmed M solely contributed to this work.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Monjur Ahmed, MD, FRCP, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, 132 South 10th Street, Suite 565, Main Building, Philadelphia, PA 19107, United States. monjur.ahmed@jefferson.edu
Telephone: +1-215-9521493 Fax: +1-215-7551850
Received: March 25, 2016
Peer-review started: March 25, 2016
First decision: May 17, 2016
Revised: June 8, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 16, 2016
Processing time: 171 Days and 0.6 Hours
Abstract

As the number of diagnostic and therapeutic gastrointestinal endoscopies is increasing, and there is an increase in number of patients taking blood thinners, we are seeing more and more patients on blood thinners prior to endoscopic procedures. Gastrointestinal bleeding or thromboembolism can occur in this category of patients in the periendoscopic period. To better manage these patients, endoscopists should have a clear concept about the various blood thinners in the market. Patients’ risk of thromboembolism off anticoagulation, and the risk of bleeding from endoscopic procedures should be assessed prior to endoscopy. The endoscopic procedure should be done when it is safe to do it.

Keywords: Acute coronary syndrome; Gastrointestinal bleeding and endoscopy; Blood thinners; Antiplatelet agents and endoscopy; Gastrointestinal bleeding and endoscopy; Anticoagulation bridge before endoscopy; Anticoagulants and endoscopy

Core tip: While patients on blood thinners undergoing endoscopic procedures are encountered in our clinical practice frequently, endoscopists need to be familiar with the various blood thinners and have a strategy to manage these patients efficiently. This article will discuss the various blood thinners including their mechanism and duration of action, and the current guidelines of performing gastrointestinal endoscopies when the patients are on those blood thinners.