People who have inflammatory bowel disease (IBD) are two to three times as likely to experience a pulmonary embolism or deep vein thrombosis (DVT) — two common and potentially life-threatening types of blood clots — as those who don’t have IBD, according to research. DVT occurs when a blood clot forms in the leg, pelvis, or arm, according to the Centers for Disease Control and Prevention (CDC). A DVT can break off and travel into the lungs, causing a life-threatening blockage called a pulmonary embolism, which can prevent blood flow and disrupt breathing. Fortunately, there are steps you can take to lessen your odds of developing a blood clot. Here’s what to know about DVT and how to protect yourself.
The Link Between UC and Blood Clots
The inflammation from UC may play a role in the development of blood clots. “Inflammation tends to drive up some factors associated with clotting, such as increased platelet count and reduced anticlotting factors,” says Dermot McGovern, MD, PhD, a gastroenterologist with Cedars-Sinai in Los Angeles. Being less active or more dehydrated or malnourished, which can happen if you have UC, may also contribute to clots, he says. Genetics may also be a factor. One study, published in October 2020 in the journal Gastroenterology, found that 15 percent of people with IBD have a genetically high risk for blood clots. These same people were 2.5 times more likely to develop a blood clot compared with their peers who have IBD but don’t carry these genes.
How to Lower Your Risk of Blood Clots
The first thing you should do is enlist the help of your doctor. “Talk with your doctor about what you can do to avoid blood clots, and think ahead to what precautions you can take if you have a flare,” says Dr. McGovern. It’s also important to try to manage your UC as best as possible. The study in the journal Gastroenterology found that three-quarters of the people who had a blood clot were in an IBD flare. Here are more steps you can take.
Know the symptoms of DVT
Only about half of people who have DVT will experience symptoms, according to the CDC. But if any of these occur, call your doctor right away:
SwellingPainTendernessSkin redness
Review your medications
Talk to your doctor about your medications, some of which can increase the risk of blood clots.
Steroids can help lessen inflammation in IBD, but research shows that these medications more than double the risk for blood clots (among the general population).Medications called JAK (janus kinase) inhibitors are approved for treating UC, but they can also increase the risk for blood clots, according to the U.S. Food and Drug Administration. If you have another risk factor for blood clotting, your doctor will likely weigh the benefits and risks before prescribing this treatment.Combined hormonal birth control methods — the pill, the patch, and the ring — are associated with a small increased risk of DVT, notes the American College of Obstetricians and Gynecologists.
This doesn’t mean you can’t take these medications — rather, this is something your doctor will take into consideration when determining the best treatment for you.
Quit smoking
Smoking makes blood platelets stickier and damages the lining of blood vessels, increasing the risk for clotting, according to the American Heart Association.
Manage your weight
Maintaining good habits that support a healthy-for-you weight is important. “There is some evidence that being overweight [or obese] may be associated with more severe UC and lead to less response to therapy,” says McGovern.
Keep clots in mind when traveling
Sitting for long stretches can make clots more likely. If you’re on a lengthy flight (or car ride), stand up and walk around frequently — about every 1 to 2 hours, according to the CDC. You can also do leg exercises: Try raising and lowering your heels while keeping your toes planted on the ground and then raising and lowering your toes while keeping your heels planted.
Prep before surgery
McGovern says that he always talks to IBD patients about their risk for blood clots when they are in the hospital for treatment. Surgery itself increases the risk for a blood clot, whether you have IBD or not. “We give patients blood thinners to try to prevent blood clots,” he says. “The vast majority of people who have severe UC have rectal bleeding, so it sounds counterintuitive that we would put someone on a blood thinner,” he explains, but the medication won’t make GI bleeding worse — and will significantly reduce your risk for developing a blood clot. Following surgery, your doctor may also want you to try to get out of bed and walking as soon as it’s safe. This is another important step in clot prevention. Discuss post-op care with your doctor.