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Wednesday, May 22, 2013
A patient in their 70s has been on coumadin for a while went to have a colonoscopy was taken off the coumadin when should the patient be put back on after the procedure.
This is a hard question, as there have not been any scientific studies looking at this question. Therefore, it is at the doctor's discretion (and there are no "wrong answers") as to when Coumadin should be restarted. Factors to be considered are what the perceived risk is of bleeding after the colonoscopy and what the perceived risk is of being off of Coumadin (i.e. is there a high risk of stroke if off of the Coumadin for too long). After taking these questions into account, the treating physicians should individualize a plan for the patient.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati