Thrombotic complications in inflammatory bowel diseases

Area of Science:

• Gastroenterology
• Hematology
• Vascular Medicine

Background:

• Inflammatory Bowel Disease (IBD), encompassing Crohn's Disease (CD) and Ulcerative Colitis (UC), is linked to elevated risks of arterial and venous thromboembolism.
• IBD patients exhibit a 2-3 fold increased risk of thromboembolic complications compared to the general population.

Purpose of the Study:

• To review the association between IBD and thromboembolic events.
• To highlight the importance of thromboprophylaxis in IBD patients.

Main Methods:

• A systematic literature search was performed across major databases (PubMed, Medline, Scopus, Cochrane).
• Keywords included "Inflammatory Bowel Disease", "Crohn's Disease and Thrombosis", "Ulcerative Colitis and Thrombosis", and "Thrombosis".
• Full articles and abstracts were analyzed, excluding case reports, letters, and commentaries lacking extractable data.

Main Results:

• Despite the absence of randomized controlled trials (RCTs) on thromboprophylaxis efficacy in IBD, the incidence of venous thromboembolism (VTE) and pulmonary embolism (PE) is significant.
• Pharmacological options include Low Molecular Weight Heparin (LMWH), Fondaparinux, and Unfractionated Heparin (UH).
• Mechanical prophylaxis is also available.

Conclusions:

• IBD patients possess a heightened risk for VTE complications.
• Thromboprophylaxis is strongly advised for all IBD patients without contraindications.
• Acute VTE management may involve fibrinolytic agents or vascular surgery in refractory cases.