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On warfarin for PE. Having bleeding from rectum. Should I go to the ER?

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Posted on Thu, 14 Nov 2013
Question: On 5mg warfarin for. a PE for 8 months. I drink 2-4 drinks/night without complications. Tonight i am bleeding from my rectum, bright red. Should I go to ER?
doctor
Answered by Dr. Vivek Chail (3 minutes later)
Hi,
Thanks for writing in.

If the bleeding is more than a few drops and not stopping, please go to ER immediately.
Hope this helps
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (3 minutes later)
How long should i wait to see if it's stopping?
doctor
Answered by Dr. Vivek Chail (32 minutes later)
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi
Thanks for writing in with an update.

Rectal bleeding is evaluated in the main two categories.

1. Follow-up in outpatients is suggested to be appropriate when:
•The patient is less than age 60.
•There is no hemodynamic disturbance.
•There is no other evidence of massive rectal bleeding.
•An obvious source of bleeding has been identified by rectal examination and/or sigmoidoscopy.

2. Immediate admission is considered appropriate when:
•The patient is over the age of 60.
•There is haemodynamic disturbance.
•There is evidence of massive bleeding.
•Aspirin, warfarin, non-steroidal anti-inflammatory drugs (NSAIDS) or other drugs likely to exacerbate bleeding are being taken.
•There is significant comorbidity

As you fall in the second category, are on warfarin medication for pulmonary embolism, you need assessment in an ER setting.

If it were 5-10 drops, you could still wait and watch. If it is more than that please go to ER immediately.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (8 minutes later)
It feels like the bleeding might be coming from a cut or a hemorrhoid outside of the rectum. There are several drops every time i wipe (over the period of an hour), but it doesn't seem to be dripping. Do i still need to go?
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.

If you are still having continuous drops of blood coming out each time you wipe, there is an urgent need to go to ER. This is keeping in mind any bleeding that is occurring internally. You need to get examined for the site of bleeding and treated accordingly. Your INR also needs assessment.

Please do not worry, you should recover soon.

Hope this helps.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6839 Questions

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On warfarin for PE. Having bleeding from rectum. Should I go to the ER?

Hi,
Thanks for writing in.

If the bleeding is more than a few drops and not stopping, please go to ER immediately.
Hope this helps