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Dr. Andrew Rynne

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Can Coumadin cause a stroke?

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 12427 Questions

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Posted on 5 days ago in Lump
Question: my wife has a scheduled colonoscopy very soon, and since she is on coumadin, we are concern about a stroke happening. she is most concern about getting very hungry during the procedure, and somehow she is very worried about it. The coumadin is being stop for about five days before the day of the colonoscopy, hence, can you kindly give some advice. Thank you.
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:

Please give additional information.

Detailed Answer:

Hi,

Thanks for your query about your wife. Noted the history and understood the concerns. Please give some more details for me to assist you better:

Were the stool tests done? If so what were the reports?
Since when she is on Coumadin?
Are there any other associated medical problems?
What is the reason she is worried about hunger during the procedure? (Please give details if she can tell the reason)
Any other information, please.

Coumadin has to be stopped before any procedure.
Is there anything that your team of medical personnel advised specifically about it?

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr T Chandrakant, General Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 3 hours later
Hello, Dr. T Chandrakant,

Briefly, my wife had a triple bypass last 5/14/11. Since then she had been on coumadin, aside from the blood pressure medications, cholesterol and taking pills such as levothyroxine, atorvastatin, lisinopril, atenolol, amlodipine, and warfarin.
She has some supplement,too, like citracal, iron and vitamin C.

About the stool test, she has not submitted one since my wife mentioned about
blood in her discharge, coupled with her being anemic, the doctor suggested the
colonoscopy. Both my wife and I submitted stool samples in the past except this
year for my wife.

My wife told me that she was diagnosed with Afiv, hence the coumadin was now
in place as part of her maintenance.

Knowing my wife for 50 years, she eats very little, but takes a lot of in-between
snacks.

As for instructions for the preparation, we are fully covered. We are truly grateful to all the people handling our situation, especially, our primary doctor.

Thank you for your prompt reply, and we would be waiting for your advice.
XXXXXXX n XXXXXXX
doctor
Answered by Dr. T Chandrakant 42 minutes later
Brief Answer:

As detailed below.

Detailed Answer:

Hello,

First of all, it is important to think about the bleeding caused by Coumadin itself as a known side effect. And holding coumadin may help a lot in control of bleeding.

Considering the age colonoscopy is necessary to rule out any pathology in the colon.

There are not many known cases of developing stroke or so after holding coumadin hence as per the data there is no need to worry about holding it.

I am sure that she will be put on alternative therapy to avoid a stroke.

The team of Doctors will surely take care of this.
Avoiding the dehydration helps a lot. Please see that she is not dehydrated at any given moment.

As for the small frequent feeding habit is, in fact, a good one but for the procedure, she will be kept nil orally for a short period of time and will be started orally asap. Hence no need to worry for hunger.

Good to know that your Doctors are very helpful hence they will take every possible precaution related to the past problems as well as for the peri-procedural timing.

So I would advise/request both of you not to worry and raise unnecessary anxiety and stress as these have a negative outcome.
Be cheerful, continue faith in your team of Doctors and paramedics and everything will be fine and uneventful.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr T Chandrakant, General Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 3 days later
Hello, again, Dr. Chandrakant,

My wife n I, are very glad to hear your advice, and truly very appreciative about it.
There is one question that is somehow not certain, that is, if the procedure would go on. I overlooked to tell you that the coumadin has some required level that the blood test result must have. It must be 1.5 or less, else the doctor can cancel the scheduled procedure.

I failed to ask why and what then is next. For sure, we shall contact them, and get an answer. In the meantime, can you weigh in on this one? I hope you can enlighten us on this issue.

Thank you, once more,

Sincerely,
XXXXXXX n XXXXXXX


Thank you so much, Dr. Chandrakant.

I was trying to log in earlier, except that the website keeps indicating i have incorrect password n email, hence, i decided to start, as if i am new. However, i requested that my question to be sent to you directly, for this, i apologize.

We are very pleased to know all about both procedures. My wife, upon reading your response, have now decided to go ahead with both endoscopy n colonoscopy this 14th.

We both thank you, and shall update you, soon.

Goodnight and God Bless you all.
XXXXXXX n XXXXXXX

What is endoscopy? How long is the procedure and the risks you take?
doctor
Answered by Dr. T Chandrakant 4 hours later
Brief Answer:

As detailed below.

Detailed Answer:

Hello,

The pros and cons of holding of Coumadin and undergoing any required procedure are weighed against each other.

Say for example the procedure is related to getting a specific diagnosis or treating a particular disease then the risk of holding coumadin have to be taken.

The blood tests are Prothrombin and the calculated value is called the international normalized ratio that is INR, and your Doctor will decide the level needed for a particular procedure.

Endo-scopy+ Endos is inside and scopy is to visualize; means looking inside is Endoscopy.

The commonly done Upper GI Endoscopy has become famous all over the world as ''endoscopy'' although any it means anything like Arthroscopy for joints, Bronchoscopy for lungs, Laparoscopy for the abdomen and so on.

Endoscopy if you mean by Upper GI Endoscopy take a few minutes only.

A colonoscopy takes more time as the scope has to be negotiated without causing complications as it goes through the flexures in the colon.

Risks related are like perforation which is very uncommon.
These are the ones which are very commonly done the procedure and has a very low rate of complications.

Hope I have answered your query.

Take care

Regards,
Dr T Chandrakant, General Surgeon
Above answer was peer-reviewed by : Dr. Nagamani Ng
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