Having an Endoscopy Procedure – Information for Patients Taking Blood Thinning Medication

You have been given this leaflet because you are due to have gastrointestinal endoscopy procedure and you are currently taking anticoagulants (blood thinners).

This leaflet will explain why your medicine may need to be reviewed before the procedure.

What is gastrointestinal endoscopy?

Gastrointestinal endoscopy is a procedure during which a healthcare professional looks at your oesophagus (food pipe), stomach and small or large bowel.

To be able to look at these areas of the body, the Clinical Team (Endoscopist) who will perform your procedure will need to use a special device called an endoscope that has a tiny camera on the end. This will be inserted into your body and will provide images for the Endoscopist to see as it is moved to the part of your body that they want to examine.

The endoscopy camera is fixed to a very flexible tube, making it able to move easily through your body. The endoscope can also take tissue samples and perform minor procedures inside your body.

The procedure is used to diagnose and treat different gastrointestinal conditions, such as cancers, ulcers, polyps and blockages caused by gallstones.

Antiplatelet and anticoagulation medication

If you are taking antiplatelet or anticoagulant medication, it is important for you and your Clinical Team (Pre-assessment Team or a Doctor/Clinical Endoscopist) to discuss whether you will temporarily need to stop this medication.

Most commonly used medications in this category are listed below, however if you are taking a medication not listed, please discuss this with your Clinical Team.

Antiplatelet medication

Examples of antiplatelet medication include:

• Aspirin

• Clopidogrel

• Prasugrel

• Ticagrelor

These are used to help prevent heart attacks, strokes and blockage of blood vessels in limbs in patients who are at risk of these conditions.

Anticoagulant medication

Examples of anticoagulant medication include:

• Warfarin

• Heparin

• Rivaroxaban

• Apixaban

• Edoxaban

• Dabigatran.

These are used to prevent blood clots and strokes in patients at risk of a variety of conditions, including atrial fibrillation (AF), mechanical replacement heart valves, deep vein thrombosis (DVT), and pulmonary embolus (PE).

Am I at risk if I am using this medication and I need an endoscopy procedure?

TThis medication reduces clotting of your blood and it is used to treat certain medical conditions where the risk of blood clots is higher than normal.

Your body forms blood clots to help you to heal, such as after a fall when the skin has broken, or after a cut. By forming blood clots, it helps to stop bleeding.

However, when the body forms unwanted clots that can be dangerous, antiplatelet or anticoagulant drugs help to stop your blood from clotting so quickly.

After a procedure such as an endoscopy, your body may need to form safe clots to help in the healing process. Because of this, we may need to consider temporarily stopping antiplatelet or anticoagulant therapy, so that normal clotting happens if there should be any bleeding.

Below are some topics that your Clinical Team will be discussing with you before your procedure:

• The type of endoscopy procedure you will be having and how will it help you.

• If there are any risks relating to the procedure.

• Which antiplatelet or anticoagulant drug(s) you are taking.

• If you can safely continue your medication while undergoing the endoscopy procedure.

• If you temporarily stop or change some or all of my medication for endoscopy, what are the risks?

• For how long will your medication need to be paused?

• Is there an alternative investigation that does not require a change to your medication?

• What are the benefits of temporarily stopping your antiplatelet or anticoagulant therapy?

• What signs should you be aware of and what should you do if you have any concerns?

• Which drug(s) will you need to stop or change?

• What day do you take the last dose of each drug?

• What day do you start any alternative medication?

• Will you need any tests to your blood clotting and when should these be done?

Below are some topics your Clinical Team will be discussing with you in regards to what you should do after your endoscopy procedure:

• What day/time do you restart your usual medication?

• What day/time do you stop any temporary alternative medications?

• What complications might occur after the endoscopy?

• What are the signs of any complications?

• Who, when and how should I seek help or advice if I suspect a complication following endoscopy?

Contact Numbers

If you have any concerns or if you need any further information, please use, the contact numbers below:

University Hospital of North Tees

Endoscopy Department
Telephone: 01641 624387
Monday to Friday, 08:00 a.m. to 06:30 p.m.

Information used in the making of this leaflet

This guidance is endorsed by the charity Thrombosis UK and the European Society of Gastrointestinal Endoscopy (ESGE) guideline update 2021 which support and educate patients and health professionals about medical conditions associated with blood clotting, and the drugs used to treat these conditions.

A full copy of the guideline is available at:

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]