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

You have been given this leaflet because you are due to have a 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 the examination of the oesophagus, stomach, small or large bowel.

To be able to look at these areas of the body, your clinical team will need to use a special device that has a tiny camera on the end. This will be inserted into your body and will provide images for the specialist 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.

If you are having this procedure and you are taking antiplatelet or anticoagulant medicines, it is important that you discuss this with your Doctor.

Antiplatelet and anticoagulation medication

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

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?

This 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.

If you are taking antiplatelet or anticoagulant medication, it is important for you and your clinician to discuss whether you will temporarily need to stop this medication.

Below are some questions that your Doctor will be happy to answer before your procedure:

• Which endoscopy procedure will I be having and how will it help me?

• Are there any risks to the procedure?

• Which antiplatelet or anticoagulant drug(s) am I taking?

• Can I safely continue my medication while undergoing the endoscopy procedure?

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

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

Below are some questions that your Doctor will be happy to answer if you consider pausing anticoagulant or antiplatelet therapy:

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

• Are there any risks involved in stopping my therapy?

• For how long will my medication be paused?

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

Below are some questions that your Doctor will be happy to answer if you need to change your medication:

• Which drug(s) do I need to stop or change?

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

• What day do I start any alternative medication?

• Do I need any tests to check my blood clotting and when should this be done?

Below are some questions that your Doctor will be happy to answer after your endoscopy procedure:

• What day/time do I restart my usual medication?
• What day/time do I stop any temporary alternative medication? 
• What complications might occur after 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?

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:

Contact numbers

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

Endoscopy Department

University Hospital of North Tees

Telephone: 01642 624387

Opening hours: 8:00am to 6:30pm

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

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Telephone: 01642 624719

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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]