DVT Risk Increase in Patients with IBD

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Deep venous thrombosis (DVT) is serious. The short-term mortality rate is about 6%. Patients who go on to have a clot travel to their lung (pulmonary embolism) have a short-term mortality rate of 20%. An estimated 300,000 deaths occur annually from PE.

Known risk factors for developing DVT include long distance travel, age over 40 years, cancer, obesity, smoking, use of birth control, surgery, and family or personal history of DVT.

Add to that list -- patients with active inflammatory bowel disease (IBD).

Matthew J. Grainge, MD and colleagues have published an online report in the the Feb. 9 issue of The Lancet which shows that non-hospitalized patients with active IBD are 16 times more likely to suffer DVT than the general population.

The researchers used records from the U.K. General Practice Research Database from November 1987 through July 2001, to match 13,756 patients with IBD against 71,672 controls without the disease.

Overall, IBD patients were 3.4 times more likely to develop a blood clot than people without IBD with an occurrence rate of 2.6 per 1,000 per person-years.

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This risk more than doubled among patients experiencing IBD flares. These symptomatic patients were eight times more likely to develop a clot as those without IBD.

Patients hospitalized for a flare-up of IBD were three times as likely to develop a blood clot as patients hospitalized for other reasons.

The authors concluded that such patients could benefit from preventative treatment to prevent blood clotting. This should be done by educating patients and their families of risk and signs and symptoms of venous thromboembolism. Patients should be encouraged to use support stockings.

Symptoms include swelling, pain, tenderness, discoloration or redness of the affected area. The skin may be warm to the touch. However, as many as half of all DVT episodes produce minimal symptoms or are completely "silent."

Preventive techniques include staying hydrated, flexing your calf muscles, and if possible getting up and walking around. Persons at moderate or high risk need to consider wearing below-the-knee compression stockings.

Related story
Long Distance Travel Puts Traveler At Risk of DVT

Source
Grainge M, et al "Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study" Lancet 2010; DOI: 10.1016/S0140-6736(09)61963-2.

Nguyen G , Yeo E "Prophylaxis of venous thromboembolism in IBD" Lancet 2010; DOI: 10.1016/S0140-6736(10)60174-2.

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