Is it safe for patients to remain on antiplatelet medication for a screening colonoscopy?

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EVIDENCE-BASED ANSWERThe answer depends on the specific antiplatelet medication. Aspirin (ASA) and nonsteroidal antiinflammatory drugs (NSAIDs) do not increase postpolypectomy bleeding (PPB) after colonoscopies, while clopidogrel (either alone or with ASA or NSAIDs) significantly increases the absolute risk of PPB (SOR: B, meta-analysis of case-control studies). ASA or NSAIDs can be continued for any colonoscopy, but clopidogrel should be withheld to allow for safe polypectomy (SOR: C, expert opinion).

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