Prevention of venous thromboembolism in hospitalized patients with inflammatory bowel disease

Venous thromboembolism is a relatively common and potentially serious complication in inpatients with inflammatory bowel disease (IBD). There are a number of pathophysiologic mechanisms for venous thromboembolism that are specific to patients with IBD that may be active. The use of anticoagulants for prophylaxis against venous thromboembolism in hospitalized patients with IBD needs to be balanced against the potential for worsening of rectal bleeding. Evidence from randomized trials suggests that heparin and low-molecular weight heparin are generally safe to use in patients with active IBD, and a number of guidelines support their use for thromboprophylaxis in this patient population.