Patients with recent use of aspirin, nonsteroidal anti-inflammatorydrugs ( NSAIDS ), or anti-clotting drugs such as clopidogreal ( Plavix ) do not appear to have an increased risk of bleeding during orafter removal of precancerous lesions in the digestive tract,according to results of a Mayo Clinic study. The findings, culledfrom a review of 1,382 procedures of patients treated at MayoClinic in Florida, are being presented at the annual meeting of theAmerican College of Gastroenterology in Washington, D.C. "Patients who have recently used these medications worry a lotabout bleeding when lesions are removed from their esophagus,stomach, or colon. This study shows that such concerns may not bewarranted," says the lead author Bashar Qumseya, M.D. |
"In the past, we told patients to discontinue these agents, ifpossible, in order to prevent bleeding. But now we know that thismay not be necessary," says Dr. Qumseya, a second yeargastroenterology fellow at Mayo Clinic Florida. "There has been a lot of discussion in the medical community aboutwhat to do with people on these medications, and we are pleased tofind this early study suggests there may not be the risk ofbleeding we once thought would occur," says senior author TimothyWoodward, M.D., a gastroenterologist at Mayo Clinic in Florida.
To conduct the study, Dr. Qumseya and his team examined MayoClinic's database of patients who received an endoscopic mucosalresection (EMR) from 1999 to 2010. An EMR is a minimally invasiveprocedure that can remove lesions from throughout the GI tract. The researchers found that bleeding during an EMR occurred in 3.9percent of patients, and that it was linked to procedures in theesophagus and stomach. Bleeding that occurred days to weeks afterthe procedure was found in 2.7 percent of patients, and wasassociated with lesions anywhere in the digestive tract that werelarger than 5 centimeters.
Use of anti-inflammatory andanti-clotting agents, however, did not increase risk of bleedingeither before or after an EMR. "It is very important that patients know the risk of all medicalprocedures, and these findings will help us do the best job we canof informing our patients about those risks," Dr. Qumseya says. The study received no funding. The authors declare no conflicts ofinterest.
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