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New laxative-free colonoscopy shows promise
May 14th, 2012
05:00 PM ET

New laxative-free colonoscopy shows promise

If you're turning 50 or you're already there, colorectal screening is in your future.  Although you would only have to be screened every 10 years (if no polyps are found), the prospect of getting prepped for procedure is a big turn-off for many.  You've probably heard some of the horror stories about the pre-screening laxatives, the taste, the amount, the ensuing "cleansing."

But for those who are a little squeamish about all that liquid going in–and coming out, a new laxative free colonoscopy might be on the horizon.  A study of 605 adults published Monday in the Annals of Internal Medicine shows this type of colonoscopy has promise.

This new exam is called a laxative-free computed tomographic colonography (CTC) or virtual colonoscopy.  Study author Dr. Michael Zalis, Director of CT Colonography at Massachusetts General Hospital says the hope is that more people will find this preparation easier to stomach and result in more people getting this life-saving test.

"When we do a virtual colonoscopy we give a safe contrast agent that patients ingest over 2 days with snacks," Zalis said. "It's about 5 milliliters, about the volume of food you would see in a ketchup packet."

The contrast is taken orally 1-3 times a day, mixes easily with a low-fiber diet a patient is consuming and shows up on an x-ray.  The feces are tagged and have a distinctive appearance on the cat scan.  The contrast is not absorbed by polyps or the colon wall.  Researchers have developed computer software that cleanses the colon images electronically.

"We observed with this laxative-free version we could identify patients who had one or more polyps 1 centimeter or greater in size and we could do that with a performance that was very similar to optical colonoscopy and in a range that many people would consider acceptable for screening.  We could detect 91% of these larger lesions, in our study, OC detected 95%.  In this study that's the difference of 1 polyp."

Currently there are 2 main types of colon screenings, says Zalis: The regular optical and the virtual colonoscopies. For the optical colonoscopy (OC), a gastroenterologist inserts a 6-foot long scope with a camera at the end into the colon.  This allows the doctor to see any polyps (pre-cancerous tumors) and immediately remove.  The patient sedated for the entire procedure, so they shouldn't feel a thing.  To prepare for this procedure, patients usually have to drink a laxative solution on the day before.  This means they are drinking anywhere between 2 quarts and a gallon of liquid until the bowels are empty.

The computed tomographic colonography (CTC), sometimes called a virtual colonoscopy, requires the same preparation, it's the test that's different. A tiny tube the size of a pinkie is inserted.  This screening uses a low-dose x-ray cat-scan instead of a scope that takes pictures of the colon that are fed into a computer and later read by a technician, after the patient has left the exam.  If polyps are found, the patient has to come back and have a regular colonoscopy to have the precancerous lesions removed.

"They both require a full laxative prep and the prep is found to be so unpleasant that it deters people from participating in screening," Zalis said. "Nobody should be dying of colon cancer.  It's a slow-growing disease."

And largely preventable.  Polyps are not cancerous, but they are a benign precursor that can  turn into cancer if left unchecked.  According to the American Cancer Society, colon cancer deaths has been dropping over the last 2 decades.  Still, there are about 104,000 new cases of colon cancer each year and approximately 51,000 deaths.

There is a  caveat when using this new type of "cleanse" - while the laxative-free test accurately detected polyps 1 centimeter (0.4 inches) and larger during the study, it was less successful finding smaller growths.  But Zalis says smaller lesions are clinically less important. "We can't ignore them, but we know that the most important lesions to get are the advanced adenomas and 90% of them are 1 centimeter or larger."

Researchers say results from this study need to be validated by another larger study.  In the meantime, Zalis is making this test available to his patients at Mass General, even though it is not yet fully covered by Medicare or insurance.  The cost for this test is not higher than a traditional virtual colonoscopy, Zalis says, because the method of cleansing the bowel is all that changes.

"We've known for a long time if we could make and validate a colon exam that was far more patient-friendly, then we might be able to bring the benefit of screening to many people who are not participating in screening and who are at risk for colon cancer, " Zalis says.

A second colon cancer study also releasing in Annals looked at whether having an immediate family member such as parents, siblings and children with adenomatous polyps (larger polyps that can turn into cancer over time) increased a person's risk of colon cancer.

Researchers looked at 12 different studies and concluded that more studies are needed before a conclusion can be made.


soundoff (93 Responses)
  1. Health Pundit

    Its nice to know we can have colonoscopy now with out the use of laxative.People will be more comfortable to go for a colonoscopy with out laxative. http://healthpundit.net

    May 14, 2012 at 18:48 | Report abuse | Reply
    • anna

      Well that is all very well, but if they find anything you still have to go for the regular colonoscopy – I think I would just go for the original why go through two procedures when one will do?

      May 15, 2012 at 08:48 | Report abuse |
    • Johnny

      I agree with Anna. Four years ago I had the "regular" colonoscopy and polyps were found. They removed two, but couldn't get the third because of the way it was growing. So I had to schedule a second colonoscopy with a surgeon to have the third one removed. Had I done a virtual colonoscopy, I would have had 3 visits to the doctor instead of two. Besides, the lemon lime flavored laxative drink wasn't as horrible as I thought it was going to be. And I made certain not to eat a ton of food before taking it.

      May 15, 2012 at 12:34 | Report abuse |
    • randall -- WHO SHALL ONE DAY RULE THE WORLD!

      I AM SO HAPPY ABOUT THIS.

      I get my poopoo tunnel checked regulary. My pooper is in great shape.

      May 15, 2012 at 12:48 | Report abuse |
    • randall -- WHO SHALL ONE DAY RULE THE WORLD!

      *******************************************************************************************************

      Health Pundit, you seem really concerned about our poopers, and that's a good thing. It's refreshing to hear from someone who obsesses about poopers without any shame or sense of irony.

      *******************************************************************************************************

      May 15, 2012 at 12:52 | Report abuse |
    • MySlant

      To Anna and Johnny:

      The laxative-free method is absolutely painless. It boggles my mind when I read your posts where you say you would rather have the test done the conventional way. No polyps may be found, and then you will have avoided suffering through the prep!

      May 15, 2012 at 16:10 | Report abuse |
    • lou50

      Just like the ones with claustrophobia that wont get in an MRI tube. So they built the less effective open tube one. So now these same clowns are putting the real people thru a double dose of exams because they wont take a laxative. If you think about it they are the ones that need it the most, everyone else wants to save their lives not compromise others.

      May 15, 2012 at 16:23 | Report abuse |
  2. kim in kentucky

    Sounds great! I've had to have 2 done and agree – the "prep" was just awful! It tasted like Lemon Pledge – ugh!

    May 15, 2012 at 07:37 | Report abuse | Reply
    • randall -- WHO SHALL ONE DAY RULE THE WORLD!

      Just curious, but how do you know what Lemon Pledge tastes like?

      May 15, 2012 at 13:04 | Report abuse |
  3. Olivia

    About time the medical profession started listening to the patients. Let's hope this doesn't come to nothing.

    May 15, 2012 at 07:37 | Report abuse | Reply
  4. Katie

    I don't mind the time spend on the porcelain throne nearly as much as having to drink a gallon fluids to get there. I'm positively gagging on it trying to get it down. And tip for doctors as well as patients – make sure there's more than one bathroom in the house.

    May 15, 2012 at 07:54 | Report abuse | Reply
    • Dood

      LOL!!!

      May 15, 2012 at 12:53 | Report abuse |
    • randall -- WHO SHALL ONE DAY RULE THE WORLD!

      You have a fresh pooper.

      May 15, 2012 at 13:33 | Report abuse |
  5. Annie

    This is great news! My first one required drinking a gallon of stuff that tasted like sweaty, dirty socks smelled–yuck. My second one wasn't much better. Hopefully this will encourage more to have the procedure done.

    May 15, 2012 at 08:38 | Report abuse | Reply
  6. Laura

    While this new prep is easier, please keep in mind that if there are polyps found, the patient will still need a traditional colonoscopy to remove those polyps. The major benefit of traditional colonoscopy is that you have the polyps removed in the same procedure (while nicely sedated), as opposed to going through two procedures, and having to pay either two co-pays (which can be significant depending on your insurance),or possibly having to pay for two costly procedures out of pocket.. As a side note, the virtual colonoscopy, as with all medical imaging, ir interpreted by a Radiologist (a medical doctor trained in imaging), not by a tech, as stated in the article.

    May 15, 2012 at 08:59 | Report abuse | Reply
    • Johnny

      I totally agree. And the laxative wasn't as bad as I thought it would be. The dr. in fact gave me tips on drinking it such as not trying to drink the whole thing at once, if nauseated walk a little bit, and avoid the cherry flavored laxative because all of his patients hated it.

      May 15, 2012 at 12:42 | Report abuse |
    • MySlant

      The prep experience is so awful. Any reasonable person of even modest financial means would easily choose to pay a co-pay twice (if polyps are found) over suffering through the preparation using the OC method.

      May 15, 2012 at 16:22 | Report abuse |
  7. dragonwife

    I thoroughly agree – I've had a few colonoscopies done (they found polyps the first time) and the prep is almost unbearable. I've never yet been able to force down the full amount of liquid; it's just too much volume, and the taste nearly makes me throw it right back up. If they can get the same results while eliminating (no pun intended) the misery of the prep, I think a lot more people would get the test done.

    May 15, 2012 at 09:03 | Report abuse | Reply
    • lulu

      I can't believe all the fuss over drinking a jug of fluid. I had my colonoscopy and don't even remember a problem with the prep work. For the good it does, the little fuss before hand is negligible.

      May 15, 2012 at 19:29 | Report abuse |
    • The Mel

      I totally agree, dragonwife! For me, the prep was MUCH worse than I expected. I couldn't get 10 feet away from the 'throne' for an entire day. By the time I was ready for the procedure, my blood pressure was so low (dehydrated) I was afraid they weren't going to do it after all the misery. To make matters worse, they couldn't 'see' the entire colon and I had to go for a barium enema immediately. Let me just say that put it over the top! I hope to God by the time I go for my next colonoscopy there's MUCH better prep and testing in place!

      May 15, 2012 at 20:18 | Report abuse |
  8. Monica

    I'll take the "prep" anytime instead the high dose radiation of CTC. The "low dose CT scanners" still deliver high dose radiation (they are called low dose because they are compared to the first multi slice scanners which were worse!)

    May 15, 2012 at 09:05 | Report abuse | Reply
  9. SPRINGSGRANNY

    Yes, the prep is not the best tasting but I had one that was mixed with Gatorade and another with just water. Gatorade was better. I just didn't like that I had to be no more than 3' from the throne for hours. That stuff works like dynomite! Still, with all that, it's better than dying from colon cancer which is curable if caught early. A necessary evil!!!!

    May 15, 2012 at 09:18 | Report abuse | Reply
  10. The_Mick

    Note that a 1 cm polyp is about the length of an adult fingernail trimmed short. Don't try to tell me that a polyp that's, say, 2/3 as big as my fingernail is "clinically less important." Since 10% of advanced adenomas are less than 1 cm, I'll put up with the laxative. You only have to drink it 3 times and there's nothing awful about it's effects. The trick is to mix it with as little flavored drink as possible so you have to drink as little as possible.

    May 15, 2012 at 09:37 | Report abuse | Reply
  11. Sam

    There is nothing in the world that would make me go thru the prep again....EVER!

    May 15, 2012 at 09:55 | Report abuse | Reply
    • Susan

      I agree with you 100%. There HAS to be a better way.

      May 15, 2012 at 12:12 | Report abuse |
  12. palintwit

    Well now Sarah Palin and her little teabaggies won't have to worry about their doctors finding out how full of sh!t they really are.

    May 15, 2012 at 10:01 | Report abuse | Reply
    • Brian in IL

      Wow, "palintwit," someone needs to get treated for excess bile.

      If you had one of these laxative treatments, I'm guessing they would be able to bury you in a matchbox.

      May 15, 2012 at 12:42 | Report abuse |
  13. Hawkdoc

    A few points to consider:
    1) Colonoscopy has been shown in published medical studies to reduce the incidence of colorectal cancer in those who have the procedure done. Although virtual colonoscopy can see large polyps, we still do not know if this will result in decreased incidence of cancer.
    2) Polyps < 1 cm in size can still develop into cancer over time. True, the larger ones are higher risk, but I would hate to miss a smaller polyp that turned into cancer.
    3) The virtual colonoscopy still requires that your colon be distended with air in order for the polyps to be obvious (otherwise you can't distinquish between mucosal folds and true polyps). That 'pinkie-sized tube' which is inserted into the anus pushes air into your colon the same way that a colonoscope would, and you're not sedated.
    4) If a polyp is seen (at least 25% of people over the age of 50 will have them), you still need a conventional colonoscopy to have them removed.

    The prep sucks, no doubt. But until virtual colonoscopy (CT colonoscopy) has been proven to actually reduce the incidence of colorectal cancer, I would stick to the traditional study. A day or to of misery is better than being diagnosed with cancer.

    May 15, 2012 at 10:09 | Report abuse | Reply
  14. Keith

    Sam: I submit that watching a loved one suffer and die from colon cancer that was not detected until too light might just motivate you to do whatever is necessary to reduce the possibility of suffering that horrible death.

    I can't really see the benefit to the "laxative free" procedure, unless it is only offered after a patient refuses the colonoscopy option. It will certainly cost the same or more and if polyps are found the patient will have the extra expense AND the laxative prep of a colonoscopy anyway. Additionally smaller polyps can be missed. A 7.5mm (3/4cm) polyp not found in the new procedure could grow large and even turn cancerous if the 10 year repeat rate of a "clean" colonoscopy is recommended based on the results of the "prepless" test.

    May 15, 2012 at 10:11 | Report abuse | Reply
    • D

      What they should do, then, is work on getting the cost of the procedure down and then screen more often with it.

      May 15, 2012 at 13:16 | Report abuse |
    • lulu

      The 10 year wait is way too long. In Canada it is 5 year. Our friend had a colonoscopy and was told he had the clearest colon they had ever seen. In 4 years he was diagnosed with colon cancer. He had part of his bowel removed, got an infection and never made it home from the hospital. His wife decided she better get a colonoscopy too and her bowel was punctured during it and had to have a section of her bowel removed.

      May 15, 2012 at 19:41 | Report abuse |
  15. Basil999

    Several folks at my work go to the same doctor and I heard "stories" about their screenings before I went (the prep, that is). I did some research and ASKED the doctor prior to going in if I could take the PILLS instead of that awful jug of nasty stuff. They don't OFFER to tell you about this...you have to ASK (unfortunate). It is not the "preferred" way, but if you are "regular" they will give you the pills if you ask for them. This option has something like 3 HORSEPILLS (if you can take these kind, it's a no brainer) you take once every 15 or 30 minutes over a period of time. It works, and the prep is NOTHING. It pays to ask questions!!!

    May 15, 2012 at 10:15 | Report abuse | Reply
    • Hawkdoc

      On the other hand, if you have a suboptimal prep and the gastroenterologist is unable to see the entire colon because of retained stool, they will recommend that you have the procedure repeated a lot sooner. This translates into more procedures over the course of your life. The pills make this scenario more likely, and that's why your doctors always recommend the better prep. If you are absolutely unable to tolerate the conventional prep, then this is an alternative. Otherwise, do yourself a favor, and arrive at the endoscopy suite with a clean colon.

      May 15, 2012 at 10:23 | Report abuse |
    • D

      Why, oh why, can't it be a greater number of smaller pills. It is like the medical profession does not care at all about people!

      May 15, 2012 at 13:22 | Report abuse |
    • Gordon

      There is a new product, on the market for about a year, called SUPREP, which I just used last week with great results (according to my gastroenterologist). Like PEG, it isn't absorbed, so kidneys are not at risk, but much less volume, 16 oz followed by plain water. Unfortunately, as you say, Basil999, they don't tell you about this unless you ask. My gastroenterologist only told me about it after I threatened to cancel my appointment if they didn't come up with something besides that gallon of fruit-flavored slime. I really do wonder it the gastroenterology community understands how many people avoid colonoscopies for that reason.

      A few comments down, Been Thru It asks about enemas. I tried that once myself (to avoid the gallon of slime), and it just doesn't work as well. My gastroenterologist told me that's the real reason they don't tell people to do it that way any more, not because people won't do it. Besides that, you have to do it multiple times, and it gets old pretty fast. That said, I'd still rather do that than drink the slime.

      May 15, 2012 at 15:22 | Report abuse |
  16. Hot Carl

    Won't the doctor run into my doodie if I'm not cleaned out?

    May 15, 2012 at 10:39 | Report abuse | Reply
    • Bristol Palin

      Mmmmmm..... doodie

      May 15, 2012 at 11:38 | Report abuse |
  17. dazzograndpa

    What a bunch of wimps! I'm 66 and have done the traditional route twice; boo hoo, you have to drink a WHOLE gallon of nasty tasting "eruption solution"...tough! Americans should get down on their knees and be thankful the test exists. If drinking the bad, old juice is the worst thing that happens to you, you're having a pretty ^%$#@!>{< good life!

    May 15, 2012 at 11:18 | Report abuse | Reply
  18. lingfing

    Doesn't anyone get told to take Pico Salax? That stuff tastes fine (it actually tastes good to me) and there's little to drink (though you do have to drink plenty of fluids of your choice afterwards). I found the prep way better than having a stomach bug (similar to having IBS). I wouldn't hesitate to do it again.

    May 15, 2012 at 11:28 | Report abuse | Reply
    • Hawkdoc

      The Picolax prep is effective and easy to tolerate. It's an osmotic laxative and contains magnesium, so it does pose some risk for people with kidney disease, or illnesses where fluid shifts can be dangerous (heart failure, liver disease, and others). The standard PEG-based preps (like GoLytely), run straight through the intestinal system without causing net absorption or secretion, so they are a little safer.

      May 15, 2012 at 11:41 | Report abuse |
    • D

      Thanks for this comment. I learned something today.

      May 15, 2012 at 13:25 | Report abuse |
  19. Been Thru It

    In the old days, large cleansing enemas were used for purging and I believe these were effective. Are they no longer used because of lack of compliance. With this prep, at least you don't have to drink a gallon

    May 15, 2012 at 11:28 | Report abuse | Reply
    • D

      Another potential solution. What I want to know is why doctors seem to think it is okay to torture people with the most commonly used prep.

      May 15, 2012 at 13:27 | Report abuse |
    • Hawkdoc

      Enemas only cleanse the distal part of the colon (sigmoid colon and rectum), without cleaning out the rest of the colon. As such, they are less effective. Plus, a lot of people are even more opposed to the idea of enemas than an oral prep.

      May 15, 2012 at 16:56 | Report abuse |
  20. Just Common Sense

    An unpleasant day with nasty prep compared to the prospect of being told you have colon cancer....really does not seem like a tough choice. Just take the discomfort and sleep well knowing you may have prevented one of the top killers in America from developing in your colon. Surgery, chemotherapy and radiation produce a lot more discomfort.

    May 15, 2012 at 11:47 | Report abuse | Reply
    • D

      Ignorant comment. Some people do not have the TOLERANCE for it. Got it? Good.

      May 15, 2012 at 13:27 | Report abuse |
  21. Don't do it~

    Fiance had regular – its 50 – colonoscopy. No polyps all clear. Within days started to develop bloating, gas, and diarrhea. Stomach distended 75% of the time, could burp all day. In bathroom 3-4 times a day. Initially thought it was reaction to test then blew it off to something he ate or stomach bug. 4 months later I ran him into ER with severe abdominal pains and blood running out of him. 7 days in hospital, hours away from exploratory surgery and possible colostomy bag for life. Nothing conclusive except his large intestine was sloughing off and severely infected. Pumped antibiotics for days. Finally calmed down. Recurring bouts of diverticulitis, still occasional bloody stools, still loose stools – this is now 2 years ago. Doctors neglect to tell folks that there is almost a 90% chance of developing an acute case of diverticulitis following a colonoscopy. A small percentage of folks get it chronically. My father did. Resident in hospital gave us this info. DO NOT clean out your intestinal flora like that! Dangerous. I just turned 50 – no colonoscopy for me....and he will never do it again...

    May 15, 2012 at 11:49 | Report abuse | Reply
    • D

      Seems like you should be okay with the virtual one then, because nothing is getting cleaned out.

      May 15, 2012 at 13:30 | Report abuse |
    • Hawkdoc

      The reason physicians 'neglect' to tell you about a 90% risk of diverticulitis following a colonoscopy - because it's simply not true. Can you imagine if it were true? With the number of colonoscopies that are done every day in this country, emergency rooms and hospitals would be full of people with diverticulitis all the time. This is absolutely untrue.

      Understand that there is a difference between diverticulosis and diverticulitis. The first is a condition that millions of Americans have and may not even know it. The colon has multiple diverticula, or outpouchings, of the colon. It's thought to be due to chronic constipation, although this isn't known for sure. For the most part, they are asymptomatic and are incidentally noticed during colonoscopy or on other imaging studies. However, they can bleed on occasion, and they can become infected. If they do become infected, then it's called 'diverticulitis,' and requires antibiotics and potentially surgery. Colonoscopies do not cause diverticulitis.

      The condition that you may be referring to is called 'bacterial overgrowth,' which occurs when the normal intestinal flora is changed for some reason (from antibiotics most commonly), and this allows other pathogenic bacteria to flourish which can cause bloating, cramping, abdominal fullness, diarrhea. This is often a chronic problem and can be treated with oral antibiotics or pro-biotics. It does not cause sloughing of the bowel wall or gastrointestinal bleeding.

      What happened to your fiance is unfortunate. It sounds to me like he may have had some bacterial overgrowth after the procedure (whether or not it was due to the bowel prep, I don't know). He may have subsequently developed diverticulitis or another colonic infection down the road, but this was unlikely from the colonoscopy. Of course, I can only guess since I wasn't involved in his care.

      It's up to you whether or not you have your colon examined. I certainly understand your trepidation after your fiance's experience. Keep in mind that whatever happened to him is extremely uncommon and difficult to pin on the procedure; and it would be a pity if you were diagnosed with metastatic colorectal cancer down the road because you didn't want a colonoscopy. It's your call.

      May 15, 2012 at 17:14 | Report abuse |
    • Jack

      "90% chance of developing an acute case of diverticulitis following a colonoscopy"? You're completely wrong and you should stop trying to scare people. I sincerely doubt that colonoscopies would be recommended by physicians if there was a 90% chance of complications. Get your facts straight.

      May 15, 2012 at 19:44 | Report abuse |
  22. radnyc

    CT scans, including CT colonographies, are interpreted by physicians (radiologists), NOT technicians like the article states. Get your facts straight CNN.

    May 15, 2012 at 11:59 | Report abuse | Reply
  23. hillbillynwv

    My grandmother died of colon cancer so I decided at the age of 42 and not 50 to have my first colonoscopy. I drank the gallon of "Go Juice" the evening before my surgery and it wasn't very pleasant needless to say. People should want to drink this because it cleans out all the undigested food in your colon which may cause cancer. A colonoscopy may save your life, so having one unpleasant evening before the procedure is well worth your life.

    May 15, 2012 at 12:22 | Report abuse | Reply
    • D

      Or, you know, just eat some fiber.

      May 15, 2012 at 13:31 | Report abuse |
    • lulu

      Some undigested food does not cause cancer.

      May 15, 2012 at 19:49 | Report abuse |
  24. dianee

    i am one of those people who must be checked every 3 years being that my dad died from colon cancer at 59 and they have already removed benign pollups from me. while i tolerate the usual drink/laxative they give me, i will be a little less scared to call for my appointment knowing the drink wont be so disgusting.

    May 15, 2012 at 12:25 | Report abuse | Reply
  25. Rob

    Virtual colonoscopies are merely CT scans of the lower abdomen. The radiation used for CT scans is horrifically high and a much higher risk to one's health than regular colonoscopies. And they are more expensive, as healthcare providers pass the cost of modern CT canners on to the patients well past the amount of time it takes to pay for the equipment. As someone who's worked in health care for more than 13 years, I'll take the unpleasant effects of laxatives over high-does radiation to my gut any day.

    May 15, 2012 at 12:45 | Report abuse | Reply
    • roy

      You know Rob- you don't know anything about radiation. Radiation used for CT scans is horrifically high? Where do you get your stupid info from. Trying to protect your turf and your job is understandable, but your uninformed blabber crossed the line. Do me a favor and the next time you have severe abdominal pain that doubles you over, go to the gastroenterologist to get a colonoscopy- stay away from the CT, lest your get "horrific radiation".

      May 15, 2012 at 13:38 | Report abuse |
  26. dg

    To "Don't do it"...very sorry to hear of your fiance's terrible experience, and I certainly hope things will improve for him. However, to suggest that there is "an almost 90% chance of developing an acute case of diverticulitis following a colonoscopy" is irresponsible. Can you cite a source for that figure? Anecdotal evidence suggests the chance is less than 1 in 1000 (probably much less...like 1 in 10,000) and when it does occur is often likely an aggravation of undiagnosed diverticulosis. Virtually all medical procedures and medications have some risk of side effects. The key is understanding the relative risk of doing nothing, versus having the test or treatment.

    May 15, 2012 at 12:51 | Report abuse | Reply
    • D

      The 90% figure did seem a bit high to me too.

      May 15, 2012 at 13:33 | Report abuse |
  27. JustaGuy

    I would think that with all the flavorings that they put in drinks now a days that someone by now would be able to make the poop juice taste better.

    May 15, 2012 at 13:21 | Report abuse | Reply
    • D

      I don't know why more effort has not been put into this. How hard can it be???

      May 15, 2012 at 13:34 | Report abuse |
    • Fifi

      You just buy a packet of drink flavoring and add it to the solution.

      May 15, 2012 at 19:20 | Report abuse |
  28. BB

    How about developing a laxative that is not so obnoxious- propbably not enough profit for the drug companies. I've tried them all but will go back to the pills next time. Could not get the Moviprep down resulting in a poor colonoscopy.

    May 15, 2012 at 13:24 | Report abuse | Reply
    • D

      Yes, this. I have been waiting for the last 5 years for some improvements in this area, and have 5 years to go. I am not that hopeful though.

      May 15, 2012 at 13:36 | Report abuse |
  29. randall -- WHO SHALL ONE DAY RULE THE WORLD!

    **********************************************************************************************************

    Everyone should get regular colonoscopies so they can have SUPER DUPER POOPERS just like ME!!!!

    I get a colonoscopy once a month. My docotor ssaid that was too much so I found a second doctor. I like to get it hard and fast!

    **********************************************************************************************************

    May 15, 2012 at 13:32 | Report abuse | Reply
    • Your Name Here

      You're an obnoxious idiot!

      May 15, 2012 at 14:17 | Report abuse |
  30. D

    Our local news had a story about an "$8 cancer test". It was essentially a fecal occult test. I would have to have something wrong there to even consider getting a colonoscopy. The nice thing about such a cheap and easy test is that it can be done more often.

    May 15, 2012 at 13:38 | Report abuse | Reply
    • Jack

      Some colon cancers don't produce symptoms so that test isn't going to catch everything. Just go have a colonoscopy. It's not that big of a deal.

      May 15, 2012 at 19:32 | Report abuse |
  31. randall -- WHO SHALL ONE DAY RULE THE WORLD!

    Fecal occult test???

    Who worships poop?

    May 15, 2012 at 13:41 | Report abuse | Reply
    • palintwit

      Why, the Palins of course.

      May 15, 2012 at 15:54 | Report abuse |
  32. Laura

    I think it's great to have options but in my case a virtual colonoscopy wouldn't have helped. I have lymphocytic colitis which can only be diagnosed through a biopsy of the colon. With LC, the colon appears normal but the biopsy shows inflammation. A regular colonoscopy was essential in my case otherwise my illness would not have been diagnosed.

    May 15, 2012 at 13:45 | Report abuse | Reply
  33. escher7

    They can say what they like – it hurts like hell. And the laxatives didn't work enough so they wasted their time anyway.

    May 15, 2012 at 13:55 | Report abuse | Reply
  34. Willam Smith

    In 2006 had first colonoscopy which removes several small polys. 2008 had blood in my stools and another colonoscopy, Two years after the one in 2006. Large polip found was cancer had to remove part of my colon surgically, which was missed completley in 2006.. If I did not have a routine stool sample in 2008 I could be dead now. Based on my experience, 10 years are to long to wait between exams. Plus there is obviously nothing sure by having a colonospopy to prefvent a cancerous polip being missed

    May 15, 2012 at 13:58 | Report abuse | Reply
  35. Miralax

    And so it is reported in the Anals of Internal Medicine.

    May 15, 2012 at 14:38 | Report abuse | Reply
  36. activeostomates

    I am a 26 year colon cancer survivor who has had more than two dozen colonoscopies. If you just do the prep right, you will have a much easier time of it.
    Proper prep for a colonoscopy:
    1. 3 days in advance switch to a liquid diet of soups, yogurt, jello, puddings, etc and take one over the counter stool softener
    2. 2 days in advance go with straight liquids, broth, ensure, water, gatorade and take another stool softener
    3. 1 day in advance just water and the night before the colonoscopy, drink the GoLitely (chilled with a little lemonaid powder) in 8 ounce shots every 15 minutes until you start to go (takes me about 4 glasses). You'll be cleaned out within an hour and feel great. Only water after that and nothing more by mouth after midnight before the procedure.

    Tip: Ask your GI doc to give you a little extra "happy juice" so you are totally out for the procedure. You'll go night night and wake up feeling fine. Be sure to ask for a video or at least a couple of still photos. If they find polyps they will be removed and biopsied. Be sure to follow up to get the results of the biopsy in full detail for your medical record.

    GET THE POLYP, GET THE CURE!
    Randy
    26 year colon cancer survivor
    http://www.randyhenniger.com

    May 15, 2012 at 14:58 | Report abuse | Reply
  37. Uncle Joe

    Having had several colonoscopies over the years I can attest that taking the laxitives are not as bad as they use to be.
    The first proceedure required me to drink a gallon of this vile stuff mixed with water. The last one was just taking three pills along with some gatoraide which didn't make me want to throw up.

    May 15, 2012 at 15:00 | Report abuse | Reply
  38. JJDLS

    This is great news the prep is horrendous to me, causes me hallucinations/chills/etc and has taken up to 12 hrs to 'work' sheer misery! 'Annals of Internal Medical" LOL

    May 15, 2012 at 15:46 | Report abuse | Reply
    • Hawkdoc

      The bowel prep causes you hallucinations? Tell your doctor, he could write a case report in the Annals of Internal Medicine! First case of bowel prep-induced psychosis.

      May 15, 2012 at 17:19 | Report abuse |
  39. Jerry

    Don't mind the traditional colonoscopy itself since I am sedated I just wish the stuff they make you drink the day before easier to stomach

    May 15, 2012 at 15:51 | Report abuse | Reply
  40. RN Deb

    A timely article for me in that I have a colonoscopy scheduled for Thursday – my first in 10 years. My father died from colon cancer 2 years ago, so even though the first colonoscopy was so bad I swore I'd never have another one (doc failed to properly anesthetize me), given my current family risks, I will get these things done as recommended. I am using a different gastroenterologist, however...

    May 15, 2012 at 16:29 | Report abuse | Reply
  41. Fifi

    The most important words here are "less successful finding smaller growths." I will stick with the tried and true "camera up the tooter" method, thank you. When I had my first colonoscopy, several polyps were found and removed immediately. All done at one go, no doubt hanging over my head that anything might have been missed, and I even got a souvenir photo of my rectum. Who could ask for more?

    Seriously, though, I lost two relatives-by-marriage to colon cancer. It is a horrible way to die. The laxative prep for a colonoscopy is no big deal. The indignity of the procedure was more of an issue for me, but that's just me. I had twilight sedation, not full sedation, so that is part of it. I had some pain when the camera got to the end of the road.

    The people who do these procedures are used to dealing with embarrassment. They tend to be kind and solicitous, and do their best to make the exam tolerable.

    Get tested!

    May 15, 2012 at 19:13 | Report abuse | Reply
  42. MIkoid

    Yay Hawkdoc!

    May 15, 2012 at 19:13 | Report abuse | Reply
  43. MIkoid

    I found the easiest way to drink the gallon of laxative was to literally hold my nose during each dose and then to immediately pop a hard candy in my mouth (no red or blue colored candies) while still holding my nose. Yes, I still did feel bloated, but I didn't taste a drop of the solution... My wife, on the other hand, tried to mix in packets of flavoring and suffered considerably choking down the laxative.

    May 15, 2012 at 19:18 | Report abuse | Reply
  44. Jack

    I am 51 and I had a "traditional" colonoscopy a few months ago. While the prep wasn't pleasant (I used Movi-Prep), it wasn't nearly as bad as many people say. Yes, it doesn't taste good (kinda like lemon flavored sea-water), it could have been a lot worse and it did what it was supposed to do- cleaned me out. The actual colonoscopy was a breeze. I was given propofol (the same drug that Michael Jackson overdosed on) and I was out for the 15 or 20 minutes that it took to do the exam. I felt nothing when I woke up and I went home and relaxed for a few hours. Overall, while I'm not looking forward to having another colonoscopy in 7-10 years, I certainly will not be dreading it because it wasn't that bad. People should stop complaining so much and be grateful that we have the technology to do these types of tests that can prevent colon cancer.

    May 15, 2012 at 19:27 | Report abuse | Reply
  45. no respect

    > and later read by a technician, after the patient has left the exam.

    Actually, that's completely incorrect.
    The scan is "read" or interpreted by a MD – a physician who has completed a residency training program more than twice the length of a family practice or internal medicine residency. I completed 7 years of residency and fellowship training in radiology. The same amount of time it takes to complete a neurosurgical residency.

    The scans are not read by technicians.

    May 15, 2012 at 19:31 | Report abuse | Reply
    • abc

      Hmmm... a little hubris from the radiologist.

      May 15, 2012 at 21:17 | Report abuse |
  46. Sue

    Surely there are other things they could try doing to make it easier? Eg giving you a hospital bed the day before so there's no drive in and you're never away from a toilet (in your own room obviously, not with a shared toilet)? Or combining the procedure with colonic irrigation so they clean you out as they go?

    The way it is at the moment sounds horrendous, and like they don't care at all how the patient feels.

    May 15, 2012 at 23:54 | Report abuse | Reply
  47. Ligayaz Lacossu

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    July 5, 2012 at 11:25 | Report abuse | Reply
  48. Renate Reich

    For a much easier prep take a series of high volume soapsuds enemas first thing in the morning, then just go to work after they are done working. Enemas are effective and stop working when you stop giving them. It helps to have assistance with enemas but I have given them to myself, so it is certainly possible! In the evening drink enough prep, e.g. Trilyte, so the liquid coming out runs clear, typically less than a quart does it. The secret is to get cleaned out really well first so the PEG solution just runs through quickly and mops up any traces the enemas miss. No cramping. Works like a charm every time!

    October 3, 2012 at 01:13 | Report abuse | Reply
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