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Fish Oil and the Risk of Post-Polypectomy Bleeding


Sheikh, Maheen MD1; Landan, Derek MD1; Gerkin, RIchard MD2; Young, Michele MD1; Kiafar, Camron DO, FACG1

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American Journal of Gastroenterology: October 2014 - Volume 109 - Issue - p S649
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Introduction: There are studies suggesting that omega-3 fatty acids in fish oil can increase the negative charge on the platelet surface causing decreased platelet function and increase bleeding time. However, data is lacking on the role of fish oil and its effect on post polypectomy bleeding (PPB) risk. Aim: to review our experience in patients who underwent colonoscopy and polypectomy while on fish oil and assess their risk of bleeding.

Methods: Retrospective chart review at Phoenix veterans affairs health care system. From July 27, 2011 to June 20, 2012, 2,975 colonoscopies were reviewed for the finding of colon polyp(s). Inclusion criteria included screening and surveillance colonoscopies with polypectomy of any size. Exclusion criteria included malignancy, incomplete documentation or an incomplete procedure. Data collected: age, body mass index, smoking history, number of polyps, size of polyps, pathology, post polypectomy bleeding, presence of diverticulosis and the use of antiplatelet/anticoagulation and fish oil.

Results: A total of 516 colonoscopies (314 for screening and 202 for surveillance) met our inclusion criteria. There were a total of 1,647 polypectomies performed (940-screening and 707-surveillance). All patients were male with a mean age of 63. There were no statistically significant differences between the fish oil and non-fish oil groups relative to; smoking, diabetes and antiplatelet/anticoagulation use (see Table 1 for demographics). There were 2 (0.39%) cases of PPB (one patient on fish oil and the second patient not on fish oil). Both cases of post polypectomy bleeding occurred within the first week of polypecotmy and did not require transfusions. Of note the patient on fish-oil had a single diminutive adenoma that was removed by cold forceps while the PPB in the non-fish oil patient was from a sessile advanced adenoma resected via snare with cautery. The 95% confidence interval (CI) for the risk of PPB while on fish oil was 2.97-3.49. The prevalence of bleeding per polyp while on fish oil was 0.67% (CI 0.02%-3.68%).

Table 1:
Patient demographics

Conclusion: The use of fish oil does not appear to increase the risk of post polypectomy bleeding even if patients had used antiplatelet or anticoagulation therapy. Our study lends further support that the risk of post polypectomy bleeding remains low.

© The American College of Gastroenterology 2014. All Rights Reserved.