Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

Clinical trials of a vaccine designed to trigger the body to attack a protein linked to colon cancer are currently being conducted by scientists at the University of Pittsburgh School of Medicine. The vaccine activates the immune system to target a defective protein which is prevalent in colorectal cancer tissue and other precancerous tissues. Researchers hope, if proven successful, the vaccine may eliminate the need for repeated colon screenings in high-risk patients. These patients tend to have multiple precancerous polyps, called advanced adenomas, in their intestines. Routine colonoscopies look for signs of recurrence of the polyps.

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While overall colorectal cancer rates are steadily decreasing, colorectal cancer rates among younger patients are on the rise, according to data collected from the 13 Surveillance, Epidemiology, and End Results (SEER) cancer registries nationwide and studied by the American Cancer Society.

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People who suffer from chronic kidney disease may be able to ward off dialysis by taking a daily dose of baking soda, according to researchers from he Department of Renal Medicine and Transplantation at the William Harvey Research Institute Barts, and the London NHS Trust in London.

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The elderly and those with certain chronic health conditions are at greater risk of suffering from complications following colonoscopies, according to a study conducted by researchers from National Cancer Institute and the University of North Carolina. The study, which was published last month in the Annals of Internal Medicine, looked at data from 53,220 Medicare beneficiaries aged 66 to 95 who underwent colonoscopy between 2001 and 2005.

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On December 11, 2008, the Food and Drug Administration (FDA) issued a safety alert calling for a black box warning on prescription oral sodium phosphate (OSP) products used to prepare the bowel prior to colonoscopies following reports of a serious form of kidney injury in patients who had taken OSP products.

The black box warning fell on Salix  Pharmaceuticals’ prescription OSP brands Visicol and Osmo Prep, and serious warning was placed on over-the-counter OSP products such as Fleet Phospho-soda and Fleet Accu-Prep. The serious adverse event that was occurring in patients repeatedly over the years was a serious form of kidney injury now known as acute phosphate nephropathy.

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A 62-year-old woman preparing for a colonoscopy followed her doctor’s orders and took a large dose of an oral sodium phosphate (OSP) solution to cleanse her bowel before the procedure. It wasn’t an unusual order. Many physicians either prescribe OSP pills or solutions for their patients or recommend over-the-counter OSP products. However, the patient’s kidneys began to fail. Doctors were able to partially resolve the problem, but the woman was left with stage 4 chronic kidney disease.

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When the Food and Drug Administration (FDA) issued a black box warning on prescription oral sodium phosphates (OSP) Visicol and Osmo Prep, medications used to clear the bowel before colonoscopies and other procedures, C.B. Fleet also removed its over-the-counter OSP solutions from store shelves. While safe when used in low doses as a laxative, those products, known over-the-counter by such brand names as Fleet Phospho-soda and Fleet Accu-Prep, when used in higher doses for bowel cleansing, have been linked to a serious form kidney injury called acute phosphate nephropathy. Despite the warnings issued here in the U.S., the products are still widely available in countries like Jamaica.

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After years of serious adverse events following the use of a type of solution used to clear the bowel before colonoscopies, Oral sodium phosphates (OSP), the products are no longer available over-the-counter and the ones available by prescription, known by the brand names Visicol and Osmo Prep, now carry a black box warning that a serious form of kidney injury has been associated with the use of the products.

Even if patients aren’t diagnosed with the type of renal failure associated with OSP use, known as Acute Phosphate Nephropathy, they may still be at risk from conditions due to electrolyte abnormalities, according to an article, Is Bowel Preparation Before Colonoscopy a Risky Business for the Kidney? published in MedScape CME.

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Two studies in the Journal of the American Society of Nephrology (JASN) suggest that at least 50 percent of patients undergoing a screening colonoscopy receive oral sodium phosphates (OSP) to prep their bowel. Which means as many as 7 million of the 14 million Americans who have regular screenings each year are at risk for a serious kidney injury that has been associated with the use of OSP. The article estimates that as many as 1,400 to 7,000 people could be injured each year by the product used routinely for bowel clearing.

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Both men and women age 50 and older, and any one regardless of age who experiences problems such as blood in the stool, intestinal pain, internal hemorrhoids, should have a colonoscopy to screen for colon cancer. If caught early, colon cancer is curable, making regular screenings imperative.

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