Is Discontinuation Of Xarelto Necessary Before A Colonoscopy?
I have been offered to take part in a research program, letting a doctor investigate the large intestine with a camera equipped instrument, so called colonoscopy, including a possible taking of a tissue example (if they find any reason to do while the colonoscopy is going on. I take anticoagulant medicine, Xarelto, 20 mg per day, after pulmonary embolism two years ago, and in relation to the fact that also have arrhythmia (atrial fibrillation). Is it wise to take part in this offer, under these circumstances? Should I refrain from Xarelto for a couple of days before the colonoscopy / tissue sample.
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Detailed Answer:
Hi and welcome.
Considering your comorbidities, especially previou spulmonary embolism, I dont think that you should undergo any "research programms" which may carry risk for some complication. However, if you did not do colonoscopy in last 10 years then it would not be just "research program" but also a recomended preventive and therapeutic procedure. This is generally low risk procedure for complications such as bleeding or colon perforation even if biopsy is done, but as I said, you should not accept it if there is no indication for it.
Second, considering lates guidelines, Xarelto should be stopped for 1 day prior to procedure. There is no need to stop it more than this since there is very low risk of bleeding and moderate risk of thrombosis so it would be good to avoid prolonged period without anticoagulation. Wish you good health. Regards
The research institute ( - which is a well known large medical institution, in fact a cooperation between two of Swedens largest hospitals) offer this "research participation" also as a preventive procedure for me and people of my age, and it is presented by them as a free offer to have a colonoscopy (and possibly a biopsy) done. If I understand you right it could be good for me to have a colonoscopy done, since I did not do it before, but maybe you recommend me to do it on my own (which could be hard, probably, in te Swedish system, if I have no diagnosis or referral to do so. (I have no private doctor).
best
XXXX
Colonoscopy can be done
Detailed Answer:
Hi XXXXXXX
Well, there is indication in your case since in developed countries there are clear guidelines that first preventive colonoscopy should be done till 55 years of age in males and optimally at 50 and then every 5-10 years depending on presence of polyps etc. So anyway, this colonoscopy is recommended for you now and in normal circumstances it includes scope of colon and biopsy or polypectomy if required so I don't see if this research participation differs from regular colonoscopy and if this is so, then this is good opportunity for you to be checked and there are no more risks comparing to regular colonoscopy.
I don't think that during this research project they will do biopsy or any other invasive additional procedure if there are no clear indication for it,but you should check this with them to be sure.
Feel free to ask any further questions
They have declared that biopsy will be made only if they see a reason to do so. I will check this again with them, and also try to get a local doctor confirm that I could participate with a one day stop of Xarelto before procedure.
Thanks a lot for clear advise.
XXXX
Hi
Detailed Answer:
Yes,you should do this.
You are welcome.