Gastrointestinal bleeding and the prevention of thromboembolism

About 2 percent of developed countries population use vitamin K antagonists (VKA), such as warfarin.These anticoagulation drugs are commonly prescribed for the purpose of thromboembolism prevention,in cases of atrial fibrillation, mechanical heart valves, deep vein thrombosis, pulmonary embolism andetc. The frequency of VKA prescription is massively increasing in the whole world. The main reason forit is the ageing of the population. As the usage of anticoagulants is increasing, doctors more often getto encounter patients with gastrointestinal bleeding taking anticoagulating drugs. The treatment of thesepatients is difficult because there are several important factors that have to be considered while choosingthe tactic of treatment, such as the intensity of bleeding, coagulation, thrombotic risk and endoscopicfindings. Even if practical guidelines partially indicate the main principles of actions for similar cases, thetreatment of bleeding patients taking anticoagulants remains seriously challenging. This article containsclinical case report and the discussion of the treatment that has been chosen in this case, based onpractical guidelines provided by American Society for Gastrointestinal Endoscopy (ASGE), EuropeanSociety of Gastrointestinal Endoscopy (ESGE) and European Society of Cardiology (ESC). This topic isalso addressed in guidelines from the American College of Gastroenterology, the American College ofChest Physicians, the American College of Cardiology, which give similar recommendations