title: Etiopathogenesis, Prevention, and Treatment of Thromboembolism in Inflammatory Bowel Disease.
abstract: The close relationship between inflammation and thrombosis affects the progression and severity of inflammatory bowel disease (IBD). The prevalence of venous thromboembolism (VTE) varies between 1% and 7% among patients with IBD. The VTE risk in patients with IBD is at least 3 times higher than that in the normal general population. The absolute risk is very high during hospitalization, active disease, and surgery. The IBD-related VTE occurs at younger ages and recurs more frequently. The development of thrombosis in IBD is due to the interaction of many hereditary and acquired risk factors. Each patient diagnosed with IBD should be evaluated for a personal and family history of thrombosis and for prothrombotic drug use. Although procoagulant factors are increased during the natural course of inflammation, natural anticoagulants and fibrinolytic activity are decreased. Although IBD is accepted as a prothrombotic condition, there is no treatment that can remove this risk from daily practice. Patient training is required to control important factors, such as long-term immobilization and smoking. Oral contraceptives and hormone replacement therapy should be avoided. Inducing permanent disease remission must be the key approach for the prevention of thrombosis. Low-molecular-weight heparin (LMWH) is the basis of prophylactic treatment, which reduces the thrombosis risk by 50%. Prophylaxis with LMWH should be administered to all patients with IBD hospitalized due to disease attack or surgery. Long-term or even life-long anticoagulation therapy should be planned if there is insufficient disease control, recurrent VTE attacks, positive thrombophilia tests, or thrombosis in vital veins.
authors.affiliation: 1 Department of Gastroenterology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Alkim
authors.affiliation: 1 Department of Gastroenterology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Koksal
authors.affiliation: 1 Department of Gastroenterology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Boga
authors.affiliation: 1 Department of Gastroenterology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Sen
authors.affiliation: 1 Department of Gastroenterology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Alkim
mesh_terms: D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D011292:Premedication / Q000379:methods; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control / Q000628:therapy
chemical_list: D006495:Heparin, Low-Molecular-Weight
keywords: hypercoagulability; inflammatory bowel disease; low-molecular-weight heparins; thrombophilia; thrombosis; thrombosis prophylaxis