The University of NottinghamA few days back we gave insights on Irritable Bowel Syndrome (IBS). Now a new study seems to offer details on people who live with Inflammatory Bowel Disease (IBD). According to scientists at The University of Nottingham, those with IBD not admitted to hospitals during flare-ups are at higher risk of blood clots as compared to those admitted to hospitals during a flare-up of their disease.

For quite some time, IBD has been known to predispose sufferers to blood clots (thromboembolism). Earlier research has indicated that most patients who develop thromboembolism appear to do so when IBD is ‘active’. They are also claimed to have a three time higher chance of suffering from a blood clot as against non-sufferers. All this, seems to have led to the use of anti-clotting drugs as standard care for patients with active IBD who are admitted to hospital.

With the novel findings, GPs and patients could possibly be offered new advice on how to lower their risk of developing this fatal side-effect of bowel disease. Interestingly, the study sought at gaining information on what the blood-clotting risk could be to patients with IBD who manage their flare-ups outside the hospital environment. This includes medical care from primary care sources like their GP.

Using the UK General Practice Research Database from November 1987 to July 2001, the team compared patients with IBD with controls who did not have the disease. It seemingly emerged that sufferers with active IBD who were not hospitalized were 16 times more likely to develop a blood clot as against the general population. The scientists examined around 13,756 patients with IBD and 71,672 matched controls.

Of these, 139 patients and 165 controls were found to have developed a blood clot. On the whole, patients with IBD had almost three and a half times higher chances of having a blood clot than the controls. However in case of a flare-up, this increase in risk was apparently much more prominent (nearly eight times). Though the absolute risk of clots seemed to have been larger for patients admitted to a hospital, this relative risk in the period of a flare-up was higher during non-hospitalized periods.

Dr Matthew Grainge, Lecturer in the University’s Department of Community Health Sciences commented, “Inflammatory bowel disease was associated with a roughly three-fold increase in the risk of venous thromboembolism. Compared with the general population while ambulatory, the risk of venous thromboembolism was increased about 16-fold for non-hospitalised patients with active inflammatory bowel disease. Despite the low absolute risks during non-hospitalised periods, these results suggest that active inflammatory bowel disease in ambulatory patients might be a far greater risk factor for venous thromboembolism than previously recognised.”

Dr Grainge’s co-researcher, Dr Tim Card added, “We believe that the medical profession needs to recognise the increased risk in people with inflammatory bowel disease when assessing the likelihood of venous thromboembolism and to address the difficulty of reducing this risk in patients with a flare who are not admitted to hospital… Such strategies to achieve a reduction in risk might include those used for inpatients such as brief courses of low-molecular weight heparin or perhaps newly available oral anticoagulants.”

The study concluded that patients were at 16 times the risk of their non-hospitalized controls than during hospitalized periods when the risk was three times that of other hospitalized patients.

The study is published in the medical journal, The Lancet.