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Triple By-pass Surgery, Red Rectal Bleeding, Stopped Plavix

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Posted on Sat, 26 May 2012
Question: my 73 yr old wife had triple by-pass April 11. Since late May she has had intermittant, and today she has bright red rectal bleeding. We thought it was plavix so she stopped it about three weeks ago. The bleeding stopped but returned today. She has an appointment with her doctor (GP) next week. What's the story about rectal bleeding after cardiac surgery?
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Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)
Hi XXXXXXX

Thanks for the query

The bleeding from the rectum could be secondary to the medicines ASA EC 81mg and Plavix taken by your wife. Acetyl Salicylic Acid (ASA EC 81mg) is a platelet aggregation inhibitor and Clopidogrel (Plavix) is an antiplatelet agent, both help in keeping platelets in the blood from sticking together and forming clots (the direct cause of most heart attacks and strokes), it is given to all the cardiac patients. As your wife has undergone triple by-pass surgery, it is very essential to prevent any clotting of the blood which would in turn cause clogging of the new grafts.

But at this age, other causes of the rectal bleeding such as malignancy of the lower Gastro-intestinal tract should also be ruled out.

She does require the following blood tests done:
1.     Complete blood count
2.     INR
3.     Clotting factors

Do not stop/start any medicines until and unless advised by your doctor. As every drop of blood is important and the more she bleeds, the more she will become weak and can lead to other complications. Take her to ER at the earliest and consult the concerned doctor.

Hope I have answered your query, if you have any more doubts you are welcome.

Regards
Dr. Naveen Kumar
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Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2540 Questions

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Triple By-pass Surgery, Red Rectal Bleeding, Stopped Plavix

Hi XXXXXXX

Thanks for the query

The bleeding from the rectum could be secondary to the medicines ASA EC 81mg and Plavix taken by your wife. Acetyl Salicylic Acid (ASA EC 81mg) is a platelet aggregation inhibitor and Clopidogrel (Plavix) is an antiplatelet agent, both help in keeping platelets in the blood from sticking together and forming clots (the direct cause of most heart attacks and strokes), it is given to all the cardiac patients. As your wife has undergone triple by-pass surgery, it is very essential to prevent any clotting of the blood which would in turn cause clogging of the new grafts.

But at this age, other causes of the rectal bleeding such as malignancy of the lower Gastro-intestinal tract should also be ruled out.

She does require the following blood tests done:
1.     Complete blood count
2.     INR
3.     Clotting factors

Do not stop/start any medicines until and unless advised by your doctor. As every drop of blood is important and the more she bleeds, the more she will become weak and can lead to other complications. Take her to ER at the earliest and consult the concerned doctor.

Hope I have answered your query, if you have any more doubts you are welcome.

Regards
Dr. Naveen Kumar