Dr. Oz Highlights the Importance of Following Bowel Preparation Instructions Before Colonoscopy

Oak Brook, Ill., June 3, 2011 /PRNewswire-USNewswire/ -- One of the most important steps in colonoscopy is patient bowel preparation to ensure that the colon is thoroughly cleaned before the exam so that the doctor can clearly see the entire colon to look for abnormalities. This week, Dr. Mehmet Oz explains in a TIME magazine article how his poor bowel preparation prior to his colonoscopy screening for colorectal cancer required him to undergo an early repeat exam after a polyp was found and how he then put off that repeat exam despite the recommendations of his doctor. The American Society for Gastrointestinal Endoscopy (ASGE), which represents the doctors who specialize in colonoscopy and colorectal cancer screening, encourages people undergoing colonoscopy to follow bowel preparation instructions carefully and to undergo follow-up exams for colorectal cancer prevention as recommended.

"Colorectal cancer is one of the most preventable cancers because the majority of colorectal cancers arise from precancerous growths in the colon called polyps, which can be found during a colonoscopy screening exam and removed before they turn into cancer," said Gregory G. Ginsberg, MD, FASGE, president, American Society for Gastrointestinal Endoscopy. "Prepping for colonoscopy is not fun.  Like many Americans, Dr. Oz did not follow the preparation instructions carefully prior to his colonoscopy, so because his colon was not thoroughly cleaned, the exam was considered unsatisfactory and his doctor recommended that he return in three months, rather than several years, to repeat the exam in case other polyps were missed. We commend Dr. Oz for highlighting the importance of colorectal cancer screening and for encouraging patients to follow bowel preparation instructions and follow-up exam recommendations as directed. A quality preparation for colonoscopy and appropriate follow-up exams save lives."

Preparing for a Colonoscopy

It is extremely important that the colon be satisfactorily cleaned before colonoscopy. This will let the doctor see any abnormalities, such as colon polyps, during the procedure. Polyps are small growths in the colon that could later turn into cancer. Cleansing the colon before a colonoscopy is called bowel preparation, or "prep." It involves taking medication that causes diarrhea, emptying the colon. The medication is taken by mouth, and comes in liquid or tablet form. Patients will also need to change what they eat during the day or two before the colonoscopy.

The doctor will prescribe the type of bowel prep that is best for each patient and will provide specific instructions. In general, here is what patients can expect:

• Your doctor will tell you to change your diet at least one day before your colonoscopy. Usually you will need to limit your diet to "clear liquids:" clear broth, tea, gelatin desserts, ginger ale, sherbet, and clear fruit juices (the ones you can see through), such as apple juice.
• You should avoid red or purple colored gelatin desserts and liquids.
• It is important to avoid dehydration during bowel prep. Drink more fluids than you usually do and all the volume recommended in your instructions.
• Your doctor will tell you exactly when to stop eating and drinking before your colonoscopy.
• Follow carefully all the steps your doctor prescribes.

Patients need to tell their doctor what medications they are taking, especially aspirin products, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel, insulin or iron products. Most medications can be continued. Some can interfere with either the prep or the colonoscopy.

For more detailed information on bowel preparation and colonoscopy, see ASGE's patient education brochures Understanding Bowel Preparation and Understanding Colonoscopy available on ASGE's website: http://www.asge.org/PatientInfoIndex.aspx?id=1022. To watch a video about what to expect before, during and after a colonoscopy, see ASGE's colorectal cancer screening website at: http://www.screen4coloncancer.org/videos.asp.

About Colorectal Cancer and Follow-up Exams

Colorectal cancer is found in the colon or the rectum, and usually develops very slowly, over a period of years, from a precancerous polyp.  A polyp is an abnormal growth of the tissue that lines the colon or rectum. The two main types of polyps are the adenomatous polyp and the hyperplastic polyp. An adenomatous polyp is a benign, precancerous growth that, if not removed, has the greatest risk of becoming cancer; a hyperplastic polyp is a benign growth with no potential to develop into cancer.

Because colorectal cancer develops slowly, screening for the disease is especially important as it allows the doctor to locate and remove polyps before they turn into cancer. For individuals at average risk, the ASGE recommends colonoscopy screening beginning at age 50 and repeating the procedure every ten years after a normal exam. For individuals with a family history, screening should begin at age 40, or at an age as recommended by their doctor. Colonoscopy is a particularly valuable method of colorectal cancer screening because it is the only method that allows for the detection and removal of precancerous polyps during the same exam and before the polyps turn into cancer, thereby preventing the colorectal cancer from occurring.

Removal of an adenomatous polyp prevents that polyp from becoming cancerous, but the patient is still at risk to develop new polyps in the colon and will require more frequent follow-up exams. If the patient has a family history of colorectal cancer, the interval for their follow-up exam may be shortened. After a colonoscopy exam, the doctor will recommend when the patient should return for another colonoscopy.

People who have been diagnosed with polyps or colorectal cancer should notify their family members of the type of polyp or cancer found and their age at diagnosis. Both factors are important in assessing family members' risk and will help their doctor determine when the family members should begin screening for colorectal cancer. Individuals with their own history of polyps are also at risk for future polyps or cancer.

Colorectal Cancer Symptoms

Colorectal cancer is often present in people without symptoms, making prevention and screening for colorectal cancer very important. A polyp may be found and removed even before it becomes cancerous or presents with symptoms; once symptoms appear, a colonoscopy is performed to aid in diagnosis, rather than screen for disease. The following signs or symptoms, however, might indicate colorectal cancer: blood in stools, narrower than normal stools, unexplained abdominal pain, unexplained change in bowel habits, unexplained anemia, and unexplained weight loss. These symptoms may be caused by other benign diseases such as hemorrhoids, inflammation in the colon or irritable bowel syndrome. The presence of these symptoms for more than a few days is an indication to talk with a gastrointestinal specialist about these symptoms and the patient's family history.

For more information on colorectal cancer prevention and to find a doctor, log on to ASGE's colorectal cancer awareness website www.screen4coloncancer.org. The site offers visitors a wealth of vital information including facts about colorectal cancer, screening options, what to expect during a colonoscopy, answers to frequently asked questions, the latest news about colorectal cancer, such as studies and statistics, links to patient support and advocacy groups, educational videos, and e-Cards.

Join ASGE's "Peter and Polly Polyp" Facebook page and spread the word to your friends about colorectal cancer prevention. Colorectal cancer is preventable, treatable and beatable!

About the American Society for Gastrointestinal Endoscopy

Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence in gastrointestinal endoscopy. ASGE, with nearly 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org and www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

About Endoscopy

Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system.

Media Contact: Anne Brownsey
(630) 570-5635
[email protected]

www.asge.org
www.screen4coloncancer.org

SOURCE American Society for Gastrointestinal Endoscopy