Risk of Hemorrhoidal Bleeding in Patients Treated with Direct Oral Anticoagulants (DOACs)

被引:0
作者
Petruzziello, Carmine [1 ]
Saviano, Angela [2 ]
Brigida, Mattia [3 ]
Migneco, Alessio [2 ]
Manetti, Luca Luigi [1 ]
Candelli, Marcello [2 ]
Ojetti, Veronica [1 ,4 ]
机构
[1] Osped San Carlo Nancy GVM Care & Res, Emergency Dept, I-00165 Rome, Italy
[2] Osped Policlin A Gemelli, Emergency Dept, I-00168 Rome, Italy
[3] Policlin Tor Vergata, Gastroenterol Dept, I-00133 Rome, Italy
[4] Univ Cattolica Sacro Cuore, Internal Med & Gastroenterol Dept, I-00168 Rome, Italy
来源
GASTROINTESTINAL DISORDERS | 2024年 / 6卷 / 03期
关键词
hemorrhoidal bleeding; DOACs; oral anticoagulant; emergency department; gut; lower gastrointestinal bleeding; endoscopic management; MANAGEMENT; ANTIPLATELET;
D O I
10.3390/gidisord6030042
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
(1) Background: Lower gastrointestinal bleeding (LGIB) accounts for 20% of all gastrointestinal bleeds. LGBI originates in the colon, rectum, and anus, mainly in patients who are receiving antiaggregant or anticoagulant treatment. The major causes are diverticular disease, colitis, hemorrhoids, and angiodysplasia. The literature studies underline that Direct Oral Anticoagulants (DOACs) are effective in reducing the risk of thromboembolic events but are associated with a higher risk of lower gastrointestinal bleeding (LGIB), particularly lower hemorrhoid bleeding. (2) Methods: The aim of our review is to revise the risk of hemorrhoid bleeding, pathophysiology, and management in patients taking DOACs in light of the most modern evidence. (3) Conclusions: central to the management of hemorrhoid bleeding in patients receiving DOAC therapy is the consideration of a tailored approach that respects the delicate equilibrium between the need for thromboembolic prophylaxis and the potential for bleeding complications. Cessation of anticoagulation, if clinically feasible, constitutes a fundamental cornerstone in the control of hemorrhage. This pause in therapy aims to mitigate the exacerbation of bleeding risk while offering a window for the implementation of local measures to manage hemorrhoid bleeding.
引用
收藏
页码:634 / 643
页数:10
相关论文
共 40 条
  • [1] Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice
    Aldhaeefi, Mohammed
    Badreldin, Hisham A.
    Alsuwayyid, Faisal
    Alqahtani, Tariq
    Alshaya, Omar
    Al Yami, Majed S.
    Bin Saleh, Khalid
    Al Harbi, Shmeylan A.
    Alshaya, Abdulrahman I.
    [J]. PHARMACY, 2023, 11 (01)
  • [2] Oral Anticoagulation Update on Anticoagulation With Vitamin K Antagonists and Non-Vitamin K-Dependent Oral Anticoagulants
    Altiok, Ertunc
    Marx, Nikolaus
    [J]. DEUTSCHES ARZTEBLATT INTERNATIONAL, 2018, 115 (46): : 776 - 783
  • [3] Review Article: Gastrointestinal Bleeding Risk with Direct Oral Anticoagulants
    Benamouzig, Robert
    Guenoun, Maxime
    Deutsch, David
    Fauchier, Laurent
    [J]. CARDIOVASCULAR DRUGS AND THERAPY, 2022, 36 (05) : 973 - 989
  • [4] Systematic review with meta-analysis: the risk of major gastrointestinal bleeding with non-vitamin K antagonist oral anticoagulants
    Caldeira, D.
    Barra, M.
    Ferreira, A.
    Rocha, A.
    Augusto, A.
    Pinto, F. J.
    Costa, J.
    Ferreira, J. J.
    [J]. ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2015, 42 (11-12) : 1239 - 1249
  • [5] Direct oral anticoagulants versus standard anticoagulation in children treated for acute venous thromboembolism
    Chen, Jie
    Bi, Guoshan
    Wu, Fei
    Qin, Xiao
    [J]. PEDIATRIC RESEARCH, 2023, 93 (06) : 1491 - 1498
  • [6] Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management
    Cheung, Ka-Shing
    Leung, Wai K.
    [J]. WORLD JOURNAL OF GASTROENTEROLOGY, 2017, 23 (11) : 1954 - 1963
  • [7] Clinical Practice Committee American Gastroenterological Association, 2004, Gastroenterology, V126, P1461
  • [8] Evaluation and Management of Lower GI Bleeding
    Drezdzon, Melissa K.
    Peterson, Kent J.
    [J]. DISEASES OF THE COLON & RECTUM, 2022, 65 (06) : 785 - 788
  • [9] Systematic Review and Meta-Analysis of Randomised Trials to Ascertain Fatal Gastrointestinal Bleeding Events Attributable to Preventive Low-Dose Aspirin: No Evidence of Increased Risk
    Elwood, Peter C.
    Morgan, Gareth
    Galante, Julieta
    Chia, John W. K.
    Dolwani, Sunil
    Graziano, J. Michael
    Kelson, Mark
    Lanas, Angel
    Longley, Marcus
    Phillips, Ceri J.
    Pickering, Janet
    Roberts, Stephen E.
    Soon, Swee S.
    Steward, Will
    Morris, Delyth
    Weightmanm, Alison L.
    [J]. PLOS ONE, 2016, 11 (11):
  • [10] Effect of Diosmin Administration in Patients with Chronic Venous Disorders on Selected Factors Affecting Angiogenesis
    Feldo, Marcin
    Wojciak-Kosior, Magdalena
    Sowa, Ireneusz
    Kocki, Janusz
    Bogucki, Jacek
    Zubilewicz, Tomasz
    Kesik, Jan
    Bogucka-Kocka, Anna
    [J]. MOLECULES, 2019, 24 (18):