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It is a very controversial issue. Western guidelines recommend to take biopsies without stopping warfarin. However, most Asian endoscopists suggest to stop taking warfarin for 3-5 days before endosopic biopsy.
Recommendataions: (1) In patients on warfarin, endoscopy without biopsy is OK. (2) In order to do endoscopy with biopsy, stop taking warfarin for 4 days before endoscopy. In this situation, coagulation profile (such as prothrombin time) is not necessary before endoscopic biopsy. (3) In exceptional cases with suspected malignant disease in endoscopy, you may take biopsies without stopping warfarin.
I got a question from an EndoTODAY reader about the bridge therapy while stopping warfarin (question in Korean).