[Aspirin and endoscopy]

Area of Science:

• Gastroenterology
• Cardiology
• Internal Medicine

Background:

• Colonoscopy is a common procedure for investigating symptoms like weight loss and iron deficiency anemia.
• Patients with stable anginal syndrome often take aspirin for cardiovascular protection.
• The management of aspirin therapy before endoscopic procedures presents a clinical dilemma.

Observation:

• A literature review and American Association for Gastrointestinal Endoscopy guidelines do not support routine aspirin discontinuation before colonoscopy.
• A recent Israeli physician survey reveals a practice pattern considering individual patient risk when deciding on aspirin cessation.
• This approach acknowledges the potential risks of aspirin withdrawal in patients with stable angina.

Findings:

• Current guidelines do not mandate aspirin cessation for colonoscopy in patients with stable angina.
• Physician practices vary, with some considering the risk of aspirin withdrawal.
• A risk-benefit assessment may guide the decision to continue or stop aspirin.

Implications:

• Continuing aspirin may align with guidelines and avoid risks associated with withdrawal.
• Individualized risk assessment can bridge the gap between guidelines and clinical practice.
• This approach aims to optimize patient safety during endoscopic procedures.