A link between ulcerative colitis and blood clots

Ulcerative colitis is an inflammatory bowel disease (IBD) that may increase the risk of blood clots. Read on to know the link between these two conditions.

Blood clots, or gel-like masses, can block blood flow, leading to severe complications like a heart attack or stroke. While blood clots can be a result of genetic factors and a sedentary lifestyle, ulcerative colitis, an inflammatory bowel disease (IBD), may also pose additional risks. Chronic inflammation in the colon can trigger clot formation due to increased levels of clotting factors. Hence, patients with ulcerative colitis should stay alert for symptoms such as swelling or redness in the legs, which may signal deep vein thrombosis, a dangerous clotting condition. Read on to learn the link between ulcerative colitis and blood clots.

What is ulcerative colitis?

Ulcerative colitis is one of the two major types of chronic inflammatory bowel disease (IBD), along with Crohn’s disease (CD). Unlike CD, which can affect any part of the digestive tract, ulcerative colitis primarily affects the colon and rectum. It may lead to inflammation and ulcers in the innermost lining of the large intestine. “Due to this, you may experience symptoms such as abdominal pain, rectal bleeding, diarrhoea (often bloody), cramps, bloating, and weight loss. It has been found that an overactive immune system may contribute to UC,” says Dr Meghraj Ingle, a Consultant Gastroenterology. However, the reason why certain immune responses target good gut bacteria, triggering intestinal inflammation, remains unclear.

Ulcerative colitis is a chronic inflammatory bowel disease causing inflammation and ulcers in the inner lining of the colon and rectum. As an inflammatory bowel condition, it can lead to changes in blood clotting factors and platelet function, making you more susceptible to clot formation. A 2022 review from the Multidisciplinary Digital Publishing Institute highlighted multiple studies showing an elevated likelihood of thromboembolic events in individuals with IBD. Thromboembolic events occur when a blood clot forms in one vessel, dislodges, and obstructs another vessel’s flow.

digestive problem
Ulcerative colitis causes digestive problems! Image courtesy: Adobe Stock

A Danish study found that individuals with inflammatory bowel disease (IBD) face double the risk of pulmonary embolism and deep vein thrombosis (DVT). Even after considering other potential risk factors such as existing health conditions or medication use, the IBD group still had an 80 percent higher risk of blood clots compared to control groups.

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“Moreover, those with ulcerative colitis (UC) often experience flare-ups, during which the inflammatory process fluctuates, further contributing to the risk of clot formation. Apart from this, medications commonly used to manage UC, such as corticosteroids and immunosuppressants, may also heighten the likelihood of blood clots,” explains Dr Ingle.

Why are blood clots problematic?

Blood clots are problematic because they can obstruct blood flow, leading to serious health complications. When a clot forms within a blood vessel, it can block the passage of blood to vital organs, causing tissue damage or organ failure. In arteries, clots can trigger heart attacks or strokes by cutting off blood supply to the heart or brain. In veins, they can cause deep vein thrombosis (DVT) or pulmonary embolism (PE), both potentially life-threatening conditions. Moreover, clots can break off and travel through the bloodstream, causing blockages in other parts of the body.

The Centers for Disease Control and Prevention (CDC) report that in the United States, one person dies from blood clots every 6 minutes. Hence, prompt detection and treatment are necessary to prevent complications and potential death

Other causes and risk factors of blood clots

Blood clots, medically known as thrombosis, occur when blood thickens and forms a clump. There are a large number of conditions that are linked with the risk of developing blood clots, such as:

  • Slow blood flow due to too much sitting
    Injuries or surgeries
  • Medical conditions (such as cancer, heart disease, and autoimmune disorders)
  • Genes
  • Smoking
  • Sedentary lifestyle
  • Obesity
  • High blood pressure
  • Hormonal fluctuations
  • Pregnancy and birth control pills
  • Dehydration
  • Certain medications
Graphic representation of a blood clot
Blood clots can be problematic. Image Courtesy: Freepik

Anticoagulant drugs are typically advised to lower the risk of blood clots. However, as per the 2014 Guidelines by the Canadian Association of Gastroenterology, these medications are suggested for patients with IBD post-surgery or during hospitalisation, not for daily blood clot prevention. So, always consult with your doctor and seek help to prevent blood clots in the long run.