Ulcerative colitis is mostly a disease that causes inflammation in the large intestine, but some people can also experience health effects beyond the intestine. Some patients with ulcerative colitis also experience hypercoagulability, which means their risks for blood clots is increased.
Keep reading to find out more about the connection between these two conditions and if anticoagulant medications are a beneficial treatment for this possible effect.
What does anticoagulation mean?
Anticoagulation means any approach that helps to lower excessive blood clotting. Doctors prescribe anticoagulant medications to people who have had blood clots or who are at risk of blood clots.
There are many different compounds in the blood that can play a role in blood clotting. Authors of one study examined laboratory values for some of these compounds to find out if they were higher in people with ulcerative colitis compared to the general population.
The authors found that people with inflammatory bowel diseases (both ulcerative colitis and Crohn’s disease) were more likely to have higher levels of fibrinogen and factor VII. Fibrinogen plays a role in blood clotting, and high levels can increase your risks for blood clotting.
Factor VII is a type of “procoagulant,” or compound that helps make a clot form. High levels of factor VII may also increase blood clotting risks.
UC and blood clotting
It’s important to remember that blood clotting is your body’s natural response to bleeding. You need your blood to clot so you won’t bleed excessively. But it’s important to keep a balance of blood clotting factors so they won’t cause you to form a blood clot when you don’t need to.
One of the more serious complications of ulcerative colitis is
Can you take blood thinners with UC?
If you have had an ischemic stroke (stroke due to a blood clot), your doctor will likely prescribe blood thinners once you’re stable after your stroke. A doctor will take into consideration your overall health, including your ulcerative colitis, when prescribing these medications.
If the benefits outweigh the risks, a doctor will usually prescribe anticoagulants to lower your risk of future blood clots.
Doctors first connected an increased risk of blood clots with ulcerative colitis when they observed young people experiencing blood clots at a younger-than-expected age. If you have ulcerative colitis, it’s important to be aware of your increased clotting risk, but also to know the incidence of a clot is about 1% to 8% of all people with ulcerative colitis.
- discoloration of your leg or red-appearing streaks
- leg pain/tenderness
- leg swelling
- part of your leg feels warm to the touch
However, clots can also travel from your legs to your lungs, which doctors call a pulmonary embolism (PE), or blood clot in the lungs.
- chest pain that worsens with breathing
- feeling dizzy
- losing consciousness
- rapid heart rate
- sudden shortness of breath
- very fast breathing
If you experience these or other clot-related symptoms, get emergency medical attention.
Clotting requires a multi-step process. Anticoagulant medications target different steps in this process to prevent clots from forming when they aren’t supposed to. However, anticoagulant medications can increase your risks for more severe rectal bleeding when you have an ulcerative colitis flare up.
For this reason, doctors won’t usually prescribe anticoagulant medications to you unless you’re in an active flare up (and usually in the hospital), after a surgery, or have already had a blood clot in the past. Each of these instances increases your risk of blood clotting.
A number of anticoagulant medications are available, and which one your doctor prescribes may depend upon how long you’re going to take it, your overall health, and even what medications your insurance will cover to help keep your costs low. There’s no one medication that’s the “gold standard” of anticoagulation treatment for a patient.
Examples of anticoagulation medications include:
- apixaban (Eliquis)
- enoxaparin (Lovenox), which is given via injection
- rivaroxaban (Xarelto)
- warfarin (Coumadin)
If a doctor does prescribe anticoagulants to you, you can ask how the medication works and why it may be the best option for you.
Living with ulcerative colitis
Getting an ulcerative colitis diagnosis can be understandably life changing. It’s important to get help and support so you can manage your condition and live well. Some resources include:
- American College of Gastroenterology
- Crohn’s & Colitis Foundation
- Connecting to Cure Crohn’s & Colitis
- IDB Support Foundation
- Bezzy IBD Community
Healthline also has a listing of numerous resources, social media pages, and blogs that can help.
Ulcerative colitis can manifest itself in a number of ways, one of them being blood clots. As such, it’s important to know the symptoms of blood clots such as swelling or discoloration in your leg.
Ask a doctor if they have concerns about your risks for blood clots, and how you can minimize these risks whenever possible. Working to keep good control over your ulcerative colitis can also help.