Anticoagulation Therapy: Gastroenterologists'' Opinion
Objectives of the Review: To take a look at the use of anticoagulants in patients with comorbid disorders, to assess gastrointestinal (GI) tolerability of oral anticoagulants, and to identify the best therapeutic options for gastroprotection. Key Points: The authors describe specific approaches to following up patients who have comorbid disorders and are taking anticoagulants. They also provide insight into drug interactions between anticoagulants and drugs that are used to treat GI diseases; and GI tolerability of anticoagulants. In addition, they provide information about periprocedural-management plans for patients with GI conditions, treatment strategies for bleeding in patients receiving anticoagulants, and the effects of food and diet. This paper also includes guidance on using anticoagulants in patients who have hypocoagulation caused by liver disorders. Conclusion: Compared to warfarin, new oral anticoagulants (NOA) are associated with a lower rate of hemorrhagic events. New oral anticoagulants should not be used in patients with liver diseases that are associated with coagulation disorders and clinically significant risk of bleeding. When NOA need to be used in patients with comorbid disorders, proton-pump inhibitors, with minimal potential for drug-drug interactions, should be used to provide gastroprotection.