Venous thromboembolism in patients with inflammatory bowel disease: focus on prevention and treatment.
Inflammatory bowel disease (IBD) patients have an increased risk of venous thromboembolism (VTE), which represents a significant cause of morbidity and mortality. The most common sites of VTE in IBD patients are the deep veins of the legs and pulmonary system, followed by the portal and mesenteric veins. However, other sites may also be involved, such as the cerebrovascular and retinal veins. The aetiology of VTE is multifactorial, including both inherited and acquired risk factors that, when simultaneously present, multiply the risk to the patient. VTE prevention involves correcting modifiable risk factors, such as disease activity, vitamin deficiency, dehydration and prolonged immobilisation. The role of mechanical and pharmacological prophylaxis against VTE using anticoagulants is also crucial. However, although guidelines recommend thromboprophylaxis for IBD patients, this method is still poorly implemented because of concerns about its safety and a lack of awareness of the magnitude of thrombotic risk in these patients. Further efforts are required to increase the rate of pharmacological prevention of VTE in IBD patients to avoid preventable morbidity and mortality.
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Alfredo
A
Papa
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Viviana
V
Gerardi
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Manuela
M
Marzo
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Carla
C
Felice
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Gian Lodovico
GL
Rapaccini
Alfredo Papa, Viviana Gerardi, Manuela Marzo, Carla Felice, Gian Lodovico Rapaccini, Antonio Gasbarrini, Internal Medicine and Gastroenterology Unit, Catholic University, 00168 Rome, Italy.
Antonio
A
Gasbarrini
D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D010349:Patient Compliance; D061214:Patient Safety; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000150:complications* / Q000517:prevention & control* / Q000628:therapy*
D000925:Anticoagulants
Anticoagulants; Inflammatory bowel disease; Low molecular weight heparin; Thromboembolic prophylaxis; Unfractionated heparin; Venous thromboembolism