Inflammatory Bowel Diseases and Thrombosis. An Update. Review Article.

Introduction: Inflammatory bowel diseases (IBD) are a group of affections characterized by a chronic inflammation of the mucosae of the digestive tract and primarily include Crohn’s Disease (CD) and Ulcerative Colitis (UC). Although much has already been studied, aetiology and pathomechanisms are still unclear. IBD patients are at risk of many complications including the risk of thromboembolic events. Thrombotic complications in this kind of patients have already been recognised and demonstrated although further considerations have to be made regarding the incidence of such kind of events. Aim and Methods: This article is intended to resume the state of the art on venous thromboembolic complications (VTE) which can affect these patients by heavily increasing morbidity and mortality rates. A literature search was conducted using Medline, Embase,Ovid Journals, and Science Direct. The keywords were “Inflammatory Bowell Disease”, “Crohn’s Disease”, “Ulcerative Colitis”, “Thrombosis” and “Inflammatory Bowel Diseases and Thrombosis”. Results: Very little is known in this respect and as extended RCTs (randomised controlled studies) have not yet been conducted it is not possible to clearly define what the clinical approach to prevention towards this complication must be. Recent studies evidence a strong correlation between IBD and VTE complications such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Available prophylaxis and treatment options include pharmacological anticoagulant therapy (LMWH-Low Molecular Weight Heparin, Fondaparinux and UH-Unfractionated Heparin) and mechanical prophylaxis. Treatment options in case of acute VTE include anticoagulant therapy, fibrinolytic agents and in selected non-responsive cases vascular surgery. Conclusions: As IBD patients have an increased risk of VTE complications, prophylaxis for VTE should be recommended in all patients who do not show contraindications to treatment.