The Pros and Cons of Colonoscopies

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December 09, 2015 | 549,253 views

Story at-a-glance

  • About 1 in every 350 colonoscopies do serious harm. The death rate is about 1 for every 1,000 procedures
  • About 80 percent of endoscopes are cleaned using Cidex (glutaraldehyde), which does NOT properly sterilize these tools, potentially allowing for the transfer of material that could easily infect you
  • Asking what solution is used to clean the scope is a key question that could save your life. Make sure it’s been sterilized with peracetic acid, to avoid potential transfer of infectious material from previous patients

By Dr. Mercola

Colon cancer is the second leading cause of cancer-related deaths in the United States. According to the Centers for Disease Control and Prevention (CDC),1 nearly 135,000 people were diagnosed with the disease in 2012, and more than 51,500 died from it.

Men and women over the age of 50 at average risk of colorectal cancer are typically recommended to get tested either by:2

  • Fecal occult blood testing (FOBT) on an annual basis, to check for signs of blood in your stool
  • Flexible sigmoidoscopy every five years
  • Colonoscopy every 10 years

Despite the fact that there are three acceptable screening methods, most doctors simply recommend colonoscopy, and researchers have found that in most instances, doctors completely fail to review all the options and the benefits and drawbacks of each with their patients.

In essence, most doctors simply choose for their patients, without going through the steps of informed consent, and most often they choose colonoscopy.

When Given Options, More People Go Through with Testing

Interestingly, recent research3 shows that when patients are allowed to choose the screening method, more people end up going through with the test. As reported by Reuters:4

“About 1,000 patients were divided into three groups and randomly assigned to get either FOBT or colonoscopy, or given a choice between the two options.

Over three years, 42 percent of participants given a choice between the tests followed through with screening and 38 percent of people assigned to get colonoscopies did so. Just 14 percent of the patients assigned to FOBT got the test done each year.”

Side Effects and Drawbacks of Colonoscopies You Need to Be Aware Of

As noted in the video above, narrated by Dr. Michael Greger, about 1 in every 350 colonoscopies end up doing serious harm. Death from colonoscopy, while rare, also does occur.

The death rate is about 1 for every 1,000 procedures,5 and with 15 million colonoscopies being done each year in the U.S., that means about 15,000 Americans die as a result of this routine procedure.

Sigmoidoscopies tend to have 10 times fewer complications, yet most doctors still recommend colonoscopy nearly 95 percent of the time.

Interestingly, other developed countries favor the FOBT stool test. Part of the reason for this is that in other countries doctors do not get paid for procedure referrals.

In the U.S. however, doctors typically do get financial kickbacks when referring patients for various procedures, and as noted by Dr. Greger, “it’s estimated that doctors make nearly a million more referrals every year than they would have if they there were not personally profiting.”

Unfortunately, most doctors also fail to inform their patients of the risks of colonoscopy, which include:6,7

  • Perforation of the colon (people at higher risk include those with diverticulitis, diseases of the colon, and adhesions from pelvic surgery)
  • Dysbiosis and other gut imbalances, caused by the process of flushing out your intestinal tract before the procedure with harsh laxatives8
  • Complications from the anesthesia. Many experts agree you should opt for the lightest level of sedation possible, or none at all, as full anesthesia increases risks
  • False positives. According the Prostate Cancer Foundation,9 an estimated 30 to 40 percent of men treated for prostate cancer have harmless tumors that would never have caused problems in their lifetime.
  • As noted by to Jessica Herzstein, a preventive-medicine consultant and member of the U.S. Preventive Services Task Force, “you’re going to die with them, not of them.”

    False positives lead to unnecessary treatments that are nearly always harmful, in addition to the anxiety a cancer diagnosis brings.

    For example, incontinence and erectile dysfunction are two common side effects of radiation therapy, and hormone therapy has been linked to osteoporosis and depression.

  • Infections caused by improperly disinfected scopes

If You Still Decide to Get Tested, BE CAREFUL, As 80 Percent of Instruments Are NOT Properly Sterilized

Dr. Greger at NutritionFacts.org12 presents yet another alternative: peppermint, which helps relax the muscles and reduce spasms in your colon. The use of peppermint during colonoscopy was suggested over three decades ago, but was never implemented. As noted by Dr. Greger in the video above:

“[C]olon spasm can hinder the progress of the scope and cause the patient discomfort. So, they tried spraying some peppermint oil at the tip, and in every case, the spasm was relieved within 30 seconds. Thirty seconds is a long time though when you have this snaking inside of you; so, the next innovation would be to just use a hand pump to flood the whole colon with a peppermint oil solution before the colonoscopy.

[It’s a] simple, safe, and convenient alternative to injecting an anti-spasm drug, which can have an array of side effects ...”

Mixing peppermint oil into barium enemas has also been shown to be effective. Even taking a few peppermint oil capsules orally, four hours before the procedure, helped speed up the procedure by reducing spasms and pain.

Should You Have Routine Colonoscopies Starting at 50?

I’m 61 and I’ve never had a colonoscopy and have no plans of ever getting one. While I believe they can be valuable as a diagnostic tool, I feel confident that with my diet (which includes daily amounts of raw turmeric) and lifestyle it’s highly unlikely I would develop colon cancer. But for many people who are at higher risk, colonoscopies may be an effective strategy. Colon cancer grows very slowly, and it’s one of the top leading cancers that kill people, so early detection is important.

Certainly, you could opt for an annual guaiac stool detection test — which checks for hidden blood in your stool — but this test also produces many false positives, and the latest evidence suggests this test doesn’t work very well. Another alternative is to get tested by flexible sigmoidoscopy13 every five years. It’s similar to a colonoscopy, but uses a shorter and smaller scope, so it cannot see as far up into your colon.14

On the upside, it’s associated with fewer complications, although you still need to check with the hospital or clinic to make sure they’re using peracetic acid to clean the device.  Ultrasounds have also proven to be of value.

Overall, visual inspection is the most reliable way to check for colon cancer, and this is what the colonoscopy allows your doctor to do. If polyps are found in their early stages, your doctor can simply snip them off right then and there. So a colonoscopy is not only a diagnostic tool, it can also serve as a surgical intervention. They take a picture of the polyp, clip it, capture it, and send it to biopsy. So it could save your life, and it’s definitely something to consider.

However, you don’t want to risk complications or infections by having the procedure done with a contaminated piece of equipment! So please remember, asking what they use to clean the scope could save your life. Only agree to the procedure in a facility that uses peracetic acid as a cleaning solution.

This is a very simple strategy that will not only protect your health, but as more people get wise to this and start demanding the use of peracetic acid, we can improve the safety for all patients undergoing these procedures.

[+]Sources and References [-]Sources and References

  • 1 Colorectal Cancer Statistics 2012
  • 2 American Cancer Society Colorectal Cancer Screening
  • 3 American Journal of Gastroenterology November 3, 2015 [Epub ahead of print]
  • 4 Reuters November 12, 2015
  • 5, 12, What to Take Before a Colonoscopy
  • 6 Natural Healthy Concepts February 4, 2014
  • 7 The Atlantic June 29, 2015
  • 8, 11 Washington Post May 19, 2015
  • 9 Prostate Cancer Foundation
  • 10 Washington Post March 30, 2015
  • 13, What to Take Before a Colonoscopy
  • 14, Should We All Get Colonoscopies Starting at Age 50?