title: Potential effects of herbal medicines and nutritional supplements on coagulation in ENT practice.
abstract: BACKGROUND
  Herbal remedies and other natural supplements have become popular alternative medical therapy. Patients using these products may present to ENT surgeons with epistaxis or with unexpected, excessive peri-operative bleeding.
  
  
  OBJECTIVE
  The purpose of this review was to consolidate the available data regarding herb-drug interactions and the direct effects of herbal medicines and nutritional supplements in isolation, regarding disturbance in haemostasis, so as to emphasise their individual importance.
  
  
  METHODS
  A literature review was performed using the Medline (PubMed) and UKMi databases.
  
  
  RESULTS
  Searches of these databases revealed 24 herbal products with documented interactions with anticoagulants and 98 herbal products with theoretical interactions with the coagulation system. Herbal products with effects on coagulation when given alone were also documented.
  
  
  CONCLUSIONS
  When encountering patients presenting with epistaxis, or in the elective surgical setting, a thorough enquiry about the use of herbal medicines is of great importance.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, William Harvey Hospital, Ashford, UK. fjaveed@yahoo.com
authors.forename: F
authors.initials: F
authors.lastname: Javed
authors.forename: A
authors.initials: A
authors.lastname: Golagani
authors.forename: H
authors.initials: H
authors.lastname: Sharp
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors
chemical_list: D000925:Anticoagulants