THURSDAY, Oct. 20 (HealthDay News) -- Researchers report that
following surgery, people with inflammatory bowel disease (IBD) may
be at increased risk for blood clots known as deep vein thromboses
and pulmonary embolisms.
Deep vein thrombosis (DVT) is a blood clot in a deep vein in the
thigh or leg -- it's best known as "economy-class syndrome," after
cases that occurred in passengers on long-haul flights. DVTs can
travel to the lungs and lead to dangerous clots there known as
pulmonary embolisms (PE).
"An increased risk of DVT and PE in patients with IBD has been evident for the past 75 years," co-authors Dr. Andrea Merrill of Massachusetts General Hospital and Dr. Frederick Millham of Newton-Wellesley Hospital, both in Boston, wrote in the study published in the Oct. 17 online edition of the journal Archives of Surgery.
However, they added that "most work in this area has not looked
specifically at patients undergoing surgery." Because surgery is
common for people with IBD, getting a better idea of their level of
risk for these clots is important, the researchers said.
According to the American College of Family Physicians, over
600,000 Americans suffer from IBD, which involves a chronic
inflammation of the intestines. Crohn's disease and ulcerative
colitis are two common forms of IBD.
In their study, Merrill and Millham looked at data from over
2,200 IBD patients and almost 270,000 patients without IBD who had
surgery at 211 U.S. hospitals in 2008.
Overall, there were 2,665 cases of DVT or PE (1 percent), but
the rate among patients with IBD was more than double, at 2.5
percent.
Interestingly, surgeries in locations away from the intestines
had an even higher rate of DVT or PE for people with IBD -- 5
percent, the investigators found.
Rates of post-surgical heart attack or stroke were not different
in IBD patients versus those without the illness, the team noted in
a journal news release.
The researchers concluded that "patients with IBD who undergo
surgery have a twofold increased risk of DVT or PE. In patients
with IBD who are having nonintestinal surgery, this risk may be
even higher. These findings suggest that standard DVT and PE
prophylaxis [prevention] should be reconsidered for this patient
group."
One expert said the new finding may have an impact on clinical
practice.
"Current guidelines do not recommend routine DVT and PE prophylaxis in patients with IBD undergoing surgery," said Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y.
However, he said that "the data presented in this study begs the
question that perhaps the approach to prevention of DVT and PE in
IBD patients undergoing routine, non-emergent surgery needs to be
reassessed."
More information
There's more on inflammatory bowel disease at the
American Academy of Family Physicians.