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A new study presented at the American College of Gastroenterology’s 74th Annual Scientific Meeting in San Diego, Calif., places new emphasis on the importance of adequate bowel preparation prior to colonoscopies. The news comes as clinicians are evaluating new bowel preparation solutions to replace popular ones that were pulled from the market or given a black box warning by the Food and Drug Administration (FDA).
The American Society of Nephrology (ASN), a group that leads the fight against kidney disease in the U.S., holds its annual meeting and scientific exposition next week as part of ASN Renal Week, October 27 – November 1, 2009. The national Renal Week was originally formed as a way to disseminate information on new advances in the science of nephrology. Since then, the educational activities have greatly expanded to meet the needs of both practicing nephrologists and renal scientists.
Movie stars and celebrities may swear by them, but medical experts agree that colon cleansing should only be done when medically necessary.
“Sometimes it is necessary for people preparing to undergo a medical procedure or examination, such as a colonoscopy or a colon x-ray,” says to Dr. Mark Larson, a gastroenterologist at Mayo Clinic in Rochester, Minn., in the Hartford Courant. “But unless a doctor has recommended it as a preparation for such procedure, I strongly discourage people from colon cleansing. It can cause traumatic injury to the colon and result in long-term medical problems.”
Internet commercials for colon cleansing products featuring the images, names and voices of Oprah Winfrey and her friend Dr. Oz are a hoax, says Winfrey and Oz, and they have filed a lawsuit in New York Federal Court to take the ads down, according to TMZ. The lawsuit claims the company is trying to cash in on the false premise that the products have been tested or recommended by Winfrey and/or Oz when they, in fact, have not. Winfrey and Oz claim the company, which sells products such as Colon Pro Cleanse, Power Colon Cleanse and Colon Max, “turn out to be credit card scams or other fraudulent schemes.”
Colonoscopies are serious business. The procedure involves sending a small camera inside the colon to search for abnormalities, including colon or rectal cancers, also known as colorectal cancer. Regular colon screenings can find polyps even before they become cancerous. By removing those polyps, one can literally dodge colorectal cancer.
Health Canada has ordered manufacturers of over-the-counter oral sodium phosphates (OSP), such as Fleet Phospho-Soda, to either re-label the products to remove any mention of bowel cleansing, or remove the products completely from the Canadian market.
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.
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.
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.
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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