Blood Thinners to Prevent Blood Clots in Inflammatory Bowel Disease
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People with IBD — including Crohn’s disease (CD) and ulcerative colitis (UC) — have chronic inflammation, which raises their risk of blood clots. Flare-ups further increase this risk. In fact, blood clots are the leading cause of death in people with IBD. The following are some examples of how inflammation plays a role in the development of blood clots:
Blood vessel dysfunction: Inflammation results in blood vessels that are more narrow and stiff.
Vascular injury: Inflammation may also lead to injury to your blood vessels.
Hemostasis: Your injured blood vessels might result in platelets sticking together to stop the bleeding. Too much platelet clumping, however, may put you at a high risk of clots.
A 2021 study also found that some people with IBD have genetic markers, which make them more than twice as likely to get blood clots.
Can IBD Increase Your Risk of Bleeding Problems From Blood Thinners?
If you develop a blood clot, your healthcare provider will weigh the benefits of preventing another blood clot and your risk of having bleeding problems — before recommending a blood thinner. The cause of your blood clot is also important to determine your duration of therapy.
While blood thinners are effective medications, it is possible to experience severe side effects, such as serious bleeding problems. But in a number of studies, blood thinners — like anticoagulants — in people with IBD aren’t connected to an increased bleeding risk when compared to no treatment with blood thinners.
In fact, anticoagulants for thromboprophylaxis (blood clot prevention) in a hospital setting are linked to fewer overall bleeding problems in people with IBD. There’s also no connection between aspirin and IBD flares that resulted in hospital visits, corticosteroid (steroid) medications, or surgeries.
What Other Factors May Raise Your Risk of Bleeding From Blood Thinners?
All blood thinners carry a risk of potential bleeding problems. The following, however, are some examples of factors that may also increase a person’s risk.
Older age: In general, older adults may easily bruise from the thinning skin that comes with age. They may also have a higher risk of bleeding problems with blood thinners, such as anticoagulants.
Genetic differences in drug metabolism: Some people might break down certain medications — like warfarin (Coumadin) — slower than the general population. This build-up in warfarin levels may increase your risk of bleeding side effects.
Other genetic risks: Some people might be more sensitive to the effects of certain medications — like warfarin — because they have less of a specific protein that warfarin needs to block.
Medication interactions: Some medications may interact with blood thinners and further raise your risk of bleeding side effects. Examples include non-steroidal anti-inflammatory drugs (NSAIDs) — like ibuprofen (Motrin or Advil) and naproxen (Aleve).
Medical conditions: Certain medical conditions may put you at an increased risk of bleeding side effects from blood thinners. Liver problems, for example, affect clotting factor protein levels, which may complicate your anticoagulant therapy.
Taking Your Blood Thinner Safely and Preventing Blood Clots
While taking blood thinners can be challenging, the following are some ways to take them safely. There are also ways to prevent blood clots.
The following are general suggestions that may not apply to everybody, depending on factors — like your other medical conditions. Talk with your healthcare provider first before making any changes.
Office visits: Keep up with your medical and lab appointments.
Falls: Notify your healthcare provider or get medical help right away if you fall or hit your head.
Side effects: Notify your healthcare provider about concerning side effects. They can advise you on what to do next.
Medication changes: Inform all your healthcare providers and pharmacists about medication changes, including supplements.
Dietary changes: Don’t make any drastic dietary changes without talking with your healthcare provider first. What you eat might interact with blood thinners.
Exercise: Staying active will usually prevent clots from forming, but choose safer activities — like walking or swimming.
Injury prevention: Depending on the activity, make sure to wear a helmet, closed-toe shoes, or gloves. Also, be careful when using sharp objects, such as knives.
Dental care: Use a soft toothbrush and waxed dental floss to prevent bleeding gums.
Fall risk: Wear non-skid slippers in the house to limit your fall risk.
Compression stockings: Consider wearing compression stockings, a sleeve, or a boot to prevent blood clots.
If you have any questions about your blood thinner, reach out to your healthcare provider or pharmacist. They can help address your concerns.
ABOUT THE AUTHOR:
Ross earned her doctorate in pharmacy (PharmD) at The University of Texas at Austin (UT Austin). Her years of experience practicing in various pharmacy settings also lead to multiple board certifications, including ambulatory care, geriatrics, and pharmacotherapy. She currently serves as the director of the PharmacyChecker international verification program.
Ross also founded Off Script Consults, a pharmacy consulting business. She strives to combine her passion for pharmacy, education, and writing to improve the quality of life and financial outcomes for people with chronic medical conditions, caregivers, and healthcare providers.
She particularly enjoys creating relatable and helpful content for her readers and viewers. For writing samples, please visit her Muck Rack portfolio. For videos, please visit her “Off Script Consults” YouTube channel.
Ross currently resides with her husband and two dogs in her home state of Texas to be closer to family. She also tries to find time for hobbies, which include rock climbing, running, and playing pickle ball.
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