Clots in colitis: Thromboembolism and beyond

Abstract

Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events, particularly venous thromboembolism (VTE), which encompasses deep vein thrombosis and pulmonary embolism. The incidence of VTE in patients with UC is significantly higher than that in the general population, and a retrospective cohort study found that patients undergoing colectomy had a notable risk of developing VTE, with rates reaching as high as 22% among patients exposed to tofacitinib within a month prior to surgery. The GETAID FOCUS study also reported a high prevalence of self-reported VTE in patients with UC, with a pooled prevalence of approximately 12% across various studies. The risk of thromboembolism in UC is multifactorial and influenced by chronic inflammation, a wide range of medications used, potential surgical interventions, and possibly genetic factors or associations that are yet to be fully defined. Recognizing the various contributing factors is crucial for developing effective preventive strategies and improving patient outcomes.

Keywords: Ulcerative colitis; Venous thromboembolism; Incidence; Risk; Surgery

Core Tip: Patients with ulcerative colitis face a significantly increased risk of thromboembolic events, particularly venous thromboembolism (VTE), compared to the general population. This study emphasizes the multifactorial nature of this risk, influenced by chronic inflammation, medication use, surgical interventions, and potential genetic factors. Additionally, the incidence of VTE varies based on geographical and ethnic/racial factors, highlighting the need for tailored preventive strategies and proactive interventions aimed at reducing morbidity associated with these complications.