The study, which was conducted by researchers at Sungkyunkwan University School of Medicine in Seoul, Korea, found that when patients drank 2 liters of warm water just prior to a colonoscopy, doctors were able to examine an average of 98.4 percent of large intestine surface. Doctors reported only examining an average of 90.6 percent of large intestine surface in patients who drank 2 liters of cold water prior to the procedure, and 92.2 percent in patients who had no water at all.

Sixty-four participants included mostly male patients, each about 33 years of age, and generally of normal weight. The patients either drank warm water, cold water, or no water along with the standard sodium phosphate solution normally prescribed for colonoscopy preparation. Ten to 11 patients in each group had previous abdominal or gynecological surgery. Twenty-one in the warm water group, 17 in the cold water group, and 17 in the no-water group, had irritable bowel syndrome, a chronic condition that can cause pain, bloating and bowel irregularities.

Under normal circumstances, patients who undergo colonoscopies are generally sedated. However, for the study, patients agreed to forgo sedation during their exams. Those who consumed warm water, in particular those 40 years of age and younger and those with irritable bowel syndrome, reported less pain both during the exam and two hours after the procedure. Patients in the warm water group also required less time for insertion and withdrawal of the examination probe.

While the findings are promising, researchers say that more studies should be done to determine how drinking warm water affects the bowel.

SOURCE: Fleet Attorney › Drinking warm water prior to colonoscopy proves effective

Proper cleansing of the bowel is necessary for doctors to see the colon clearly. Inadequate cleansing could prevent doctors from detecting polyps or other precancerous growths and may require repeat procedures. Doctors order a specific protocol for their patients, which usually involves a type of laxative that is either taken as a pill or a solution. Both are available over the counter or by prescription.

There are different types of laxatives available. One is a polyethylene glycol electrolyte solution. Brand names of this type of product include GoLYTELY and MoviPrep. This solution increases the amount of water in the intestinal tract to stimulate bowel movements. It also contains minerals that work to replace electrolytes that are passed from the body with the stool.

Another type of laxative – available in both solution and pill form – is oral sodium phosphate, or OSP. There are several brands of OSPs, including the prescription tablets Visicol and Osmo Prep, and over-the-counter solutions such as Fleet Phospho-soda. While effective, concerns have been raised recently over the safety of OSP.

Last year the Food and Drug Administration (FDA) issued a black box warning on prescription OSP products, and Fleet pulled its over-the-counter OSP products from shelves, after numerous reports of a serious kidney injury were linked to use of OSPs. While the elderly are at higher risk, in some cases the serious adverse events occurred in patients with no pre-existing health conditions that would have otherwise put them at higher risk for kidney injury.

SOURCE: Fleet Attorney › Prepping bowel for colonoscopy is ‘necessary evil’

Colonoscopies can be lifesavers, identifying colon and rectum polyps even before they become cancerous. Doctors recommend patients begin regular colon screenings at age 50, or earlier if they have a family history of or symptoms suggestive of colorectal cancer, such as blood in the stool.

Somewhere between age 75 and 85, your doctor may discuss ceasing your regular colonoscopy screenings. This is because the risk of complications increases among older patients. Serious complications are rare, but include perforations during the exam and adverse reactions to the laxatives used to cleanse the bowel prior to colonoscopy.

Earlier this year the Food and Drug Administration (FDA) issued a black box warning on some products used to prep the bowel prior to procedures such as colonoscopies. Those products, called oral sodium phosphates, or OSPs, were available both as a pill prescribed by doctors and solutions available over-the-counter, such as those made by Fleet.

While the FDA deemed that the over-the-counter OSP products were safe when used in lower doses as a laxative, when used in higher doses to cleanse the bowel many patients began to suffer from serious kidney injuries. The kidney injuries often occurred within a day or two, but sometimes as much as weeks or months later. One diagnosis specifically for patients who suffered ill effects from OSPs is acute phosphate nephropathy.

While the reaction most often occurs in older patients, younger ones are not immune. As a result of the black box warning on prescription OSPs Visicol and Osmo Prep, Fleet withdrew its over-the-counter OSP solutions from the market.

Since then, numerous lawsuits have been filed against the makers of OSP products for not fully warning about the risk of serious kidney injury. “In some cases, these serious adverse events occurred in patients with no pre-existing health factors that would have put them at risk for developing kidney injury,” says Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.

SOURCE: Fleet Attorney › Colonoscopy prep important, but beware of OSP solutions