Jefferson Offers Patients New Option: Cut Colonoscopy Preparation Time from Two Days to One Day
Colonoscopy is a highly effective way of detecting pre-cancerous polyps. However, many people refrain from taking the test because the colon cleansing preparation needed for the procedure can be time consuming and subsequently affect a person’s quality of life. Typically, medication is started the night before and then taken again the morning of the procedure.
But now gastroenterologists at Thomas Jefferson University Hospital are offering a new option for colonoscopy patients. Colon cleansing medication can be taken entirely the morning of the procedure – in just two doses separated by three hours. Jefferson physicians are hopeful that this time shift motivates more people to get colonoscopies and aid in the effort to ultimately prevent colon cancer.
“The real advantage of morning prep is that it has less interference on patients’ quality of life,” says David Kastenberg, M.D., gastroenterologist at Thomas Jefferson University Hospital. “Many patients complain about trouble sleeping after taking the colon prep the night before. Also, it lessens the impact on work-related function and activities of daily living. Perception is also key. Patients may well tolerate the colon prep and procedure better if it’s a one day event versus two.”
In a 2010 study published in American Journal of Gastroenterology, Dr. Kastenberg and his fellow researchers found that colonoscopy preparation medication taken the same day as the procedure is equally effective to those given the night before and the morning of the procedure, but results in less sleep loss, workday interference, as well as less complaints of side effects. Journal Watch, a journal article review group sponsored by the New England Journal of Medicine, ranked Dr. Kastenberg’s study as one of the top 10 gastrointestinal journal articles of 2010.
“For years, patients have been taking the colon prep solution the night before and had successful colonoscopies the following day but had to endure numerous side effects,” explains Dr. Kastenberg. “But we now know that we can administer the colon prep the same day and get equal results. The colonoscopy images are just as good, while reducing and in some cases eliminating the side effects – such as abdominal pain, bloating, nausea and vomiting.”
The morning only colon preparation is not for patients with certain medical conditions. For instance, most diabetics have morning colonoscopy appointments, due to their dietary needs and maintaining insulin levels.
Every year, more than 14 million Americans have colonoscopies. The procedure detects pre-cancerous polyps. Unchecked, these polyps can lead to colon cancer which is one of the top three leading causes of cancer-related deaths among men and women in the United States.
The healthy, average-risk person should be screened for colon cancer starting at age 50, says Dr. Kastenberg. Those with a higher-risk, including those with a first-degree relative having colon cancer or rare cancer syndromes, should talk with their physician about being screened before age 50.
A colonoscopy that comes back normal for a healthy, average risk person lasts 10 years. Guidelines are followed about how often a colonoscopy is needed for those who are high-risk, or who have had adenomatous polyps removed during a colonoscopy.
Colonoscopies are performed under twilight anesthesia. Patients typically recover quickly and are asked to not exercise the remainder of the day. It is also recommended that they stay hydrated after the procedure by drinking a lot of fluids.
“Colon cancer is a common and preventable disease, but only half of eligible patients undergo screening,” said Kastenberg. “Anything we can do that provides additional comfort without affecting results should be considered. If we can make the patient’s experience easier and demonstrate to future patients that the procedure from beginning to end will only last one day, then maybe some of the many Americans who should be screened, but aren’t, will come forward and we might be able to save some lives.”
Media Only Contact:
Jennifer McGowan-Smith
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 8/16/2011