In a new study, researchers found that people who are being treated with blood-thinning drugs for irregular heartbeat should always be checked for bowel cancer if they experience gastrointestinal bleeding.
The research was conducted by a team at the University of Copenhagen.
If doctors see bleeding in patients with atrial fibrillation, they may assume that it is due to oral anticoagulant drugs and alter the treatment rather than check for bowel cancer.
But this study of nearly 125,500 Danish patients with atrial fibrillation shows that those who experienced bleeding were between 11 and 24 times more likely to have bowel cancer, compared to patients who did not have gastrointestinal bleeding.
The team found that between 4% and 8% of atrial fibrillation patients who experienced bleeding from their lower gastrointestinal tract were diagnosed with bowel cancer.
Less than 1% of patients were diagnosed with bowel cancer if they did not have bleeding.
These high risks of bowel cancer linked to bleeding provide a strong argument that if blood is detected in the stools of patients being treated with oral anticoagulants, this is something doctors should worry about.
The findings underline the important point that patients with gastrointestinal bleeding should always be offered meticulous clinical examination, irrespective of whether or not they are taking anticoagulants.
It should not be dismissed as a mere consequence of anticoagulant treatment.
The team says this study is also a reminder that educating and informing our patients is of utmost importance.
When patients start taking anticoagulants, doctors should tell them that if they see blood in their stools they should always consult their doctor.
A timely examination could potentially provide early detection of bowel cancer.
Patients with atrial fibrillation are often prescribed oral blood-thinning drugs, such as warfarin, dabigatran, rivaroxaban, and apixaban, to prevent the formation of clots that can lead to stroke.
However, bleeding from the gastrointestinal tract can be a side effect and is estimated to occur in about one to two percent of these patients each year.
There is no suggestion that oral anticoagulants cause bowel cancer.
One author of the study is Dr. Peter Vibe Rasmussen from Herlev-Gentofte University Hospital.
The study is published in the European Heart Journal.
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