Dangers of colonoscopy

[Voyageur]

Came across an interview by Dr. Mercola's with a Dr. David Lewis. This doctor is "a retired microbiologist with the Environmental Protection Agency (EPA)."

The reason for bringing this up has to do with many women I know who have all been prescribed this treatment of colonoscopy; like a swarm/cluster of prescriptions from physicians suddenly became widespread. I know this becomes a greater for plus 50 years of age people, too. However, this struck me as odd that so many women (all friends or colleagues), my partner included, were suddenly facing this procedure with no real problems other than a blood test that had markers to indicate that a colonoscopy was required. Then I thought, what's with that, wondering if a notice had gone out from the CMA (AMA in the States) to start screening women (maybe men too) more frequently. Then I thought, well perhaps the threshold bar for blood in stool samples had been lowered - I don't know, yet all of a sudden many diagnostic prescriptions were be issued, and it has the women obviously scared. I don't know if as many men are being tested.

Nonetheless, my partner feels just fine and so do the other women and cannot understand, however, they were and are being bombarded with calls from the prescreening agencies (tied I think to the Cancer society). The questions asked in the screenings, or so I was told, were upsetting and once an appointment was made very little information was forthcoming. Since, my partner drove one of here friends to an appointment for this procedure at hospital, and said friend had prepared herself as prescribed; and it sounded horrible, she was very ill from it. During surgery they drugged her up using some form of fentanyl - considered safe https://www.ncbi.nlm.nih.gov/pubmed/17762959 The surgeon not only used a scope from behind yet also during the procedure went down her throat. A nurse we know said this should not have happen; far to invasive.

This woman was so overcome by the procedure that my partner, during the long drive back home, actually feared for her as she was very sick on the way home. Two days later things became worse and finally she checked herself into the hospital whereby she was assessed as having a very bad infecting in her stomach and put on antibiotic drip.

With my partner, somehow she has fallen through the cracks on this (lost paper work or something), and although other women have been called, they have forgotten about her. I'm pretty sure she will not follow through with the procedure even if they do call, and it has been a few months now.

Concerning the infection described above and Dr. David Lewis, here is some of what Dr. Mercola had to say in his article, and this is aside from the 14 page interview with this microbiologist who discusses; not insofar as the procedure, yet described the instruments and the microbiology - the full interview reveals a lot, osit (link to full Pdf paper here):

Sterilization of Endoscopes
:
A Special Interview with
Dr. David Lewis
By Dr. Joseph Mercola

As discussed in my interview with Dr. David Lewis, a retired microbiologist with the Environmental Protection Agency (EPA) last year, non-disposable tools such as flexible sigmoidoscopes and colonoscopies are also risky for the patient. Since they must be reused, these tools require cleaning and sterilization before each use, both inside and out. However, testing reveals that this is virtually impossible, and the disinfection process used by most clinics and hospitals fails to properly clean and sterilize these tools.

As a result, patients take great chances when these tools are used on them, as they can spread all manner of infections from one patient to another. There is a solution: create flexible scopes that can be autoclaved (heat sterilized). But manufacturers have not been pressured to come up with such a design. As noted by Lewis, it really boils down to federal agencies failing to take the contamination issue seriously enough.

If you’re having a colonoscopy done, or any other procedure where a flexible endoscope will be used, be sure to ask how it is cleaned, and which cleaning agent is being used.

If the hospital or clinic uses peracetic acid, your likelihood of contracting an infection from a previous patient is very slim.
If the answer is glutaraldehyde, or the brand name Cidex (which is what 80 percent of clinics use), cancel your appointment and go elsewhere.

Asking what they use to clean the scope is a key question that could save your life. It’s important that we all start to do this because the FDA simply does not have the incentive to take action on it.

However, once enough people refuse to have these procedures done with glutaraldehyde-sterilized instruments, then clinics and hospitals will change, even if the FDA does nothing. It’s also crucial that health care professionals who are reading this start addressing the issue from the inside. You really need to be aware of this issue, and how it’s placing patients at risk.

As for flawed surgical tools, there’s very little you as a patient can do about it. Ideally, hospitals everywhere would hire someone to carefully inspect all surgical tools prior to use. In all, Poling’s report reveals there is much room for improvement in this industry, if we are to place patient welfare first.

My partner brought along another friend down for screening today and, apparently, she asked the nurse about the sterilization process, and in authoritarian fashion, was told to mind her own business as we know what we are doing.

Anyhow, if this helps, great. If there are other things to know or errors here on this subject, I would appreciate the feedback as forewarned is forearmed.

 

[Yupo]

Re: The subject of colonoscopy

There are some pushes/mandates/arm twisting in USA for physicians to use 'certified' electronic health records (EHRs). There are substantial cash bonuses ($40K/provider) for compliance and pay penalties (progressive percentage pay cuts each year) for non-compliance, as examples. The EHR programs have dinger systems in them to flag any patients not up to date on vaccinations, screening exams, etc. I think these boxes must be ticked to get certification credit for the patient encounter (attestation). I think one has to explain any deviation from the prescribed course to get on with the encounter credit. I say I think, because I am not participating in this program, just watching the stuff as it comes up on the computer screen. At some point soon it will become a requirement to keep records this way.
My best guess is that the increase in screening recommendations is coming from pushes within these systems, based on maybe NIH recommendations.
Also worth noting is that the ACA compliant health insurance policies are big on screening exams. When I had one of these policies, I'd be getting letters and robo-calls very often (at least weekly) about getting some kind of invasive screening I was overdue for.

 

[Nienna]

Re: The subject of colonoscopy

There are some pushes/mandates/arm twisting in USA for physicians to use 'certified' electronic health records (EHRs). There are substantial cash bonuses ($40K/provider) for compliance and pay penalties (progressive percentage pay cuts each year) for non-compliance, as examples. The EHR programs have dinger systems in them to flag any patients not up to date on vaccinations, screening exams, etc. I think these boxes must be ticked to get certification credit for the patient encounter (attestation). I think one has to explain any deviation from the prescribed course to get on with the encounter credit. I say I think, because I am not participating in this program, just watching the stuff as it comes up on the computer screen. At some point soon it will become a requirement to keep records this way.
My best guess is that the increase in screening recommendations is coming from pushes within these systems, based on maybe NIH recommendations.
Also worth noting is that the ACA compliant health insurance policies are big on screening exams. When I had one of these policies, I'd be getting letters and robo-calls very often (at least weekly) about getting some kind of invasive screening I was overdue for.

Interesting. I had a colonoscopy done twice, many, many years apart. After the last one, I was sent several letters weeks apart telling me that I really should have another. I am quite a bit over 50. When I went in for the last one, there were as many men as women there so I think they are targeting everyone. The doctors were quite upset that I didn't want to go in for another. Just like they are upset over me not wanting a mammogram. So what you wrote quite explains it.

 

[Chu]

Anyhow, if this helps, great. If there are other things to know or errors here on this subject, I would appreciate the feedback as forewarned is forearmed

I think Yupo might be onto something. It could simply be a matter of financial gain. Maybe they are pushing for it because it's expensive in some countries? I had never heard of those complications, but they make sense, and one should always make sure about hygiene. That said, I know several people who had colonoscopies (including my mother, who had colon cancer at the age of 50 and 53 and that's how they detected it). Nobody I know of has ever had a bad effect from it, and in all those cases, they actually benefited from the study and were able to get some treatment or surgeries in time. Obviously, with a proper diet and a good microbiota nobody SHOULD need this, but at least it's not as invasive as other procedures. Mammographies are known to cause more problems than what they prevent, but I would think that colonoscopies are quite safe.

 

[Persej]

That said, I know several people who had colonoscopies (including my mother, who had colon cancer at the age of 50 and 53 and that's how they detected it). Nobody I know of has ever had a bad effect from it, and in all those cases, they actually benefited from the study and were able to get some treatment or surgeries in time. Obviously, with a proper diet and a good microbiota nobody SHOULD need this, but at least it's not as invasive as other procedures. Mammographies are known to cause more problems than what they prevent, but I would think that colonoscopies are quite safe.

Yeah, I also know a lot of people who did it and nobody had complications from it. But it is very painful for many people. But not for my mother, for some reason, who said that she could do it every week if she had to. For her, gastroscopy is much worse. For other people it is the opposite. The bad thing about it is that you have to clean your colon before colonoscopy, so a good probiotic protocol after it is highly recommended.

 

[nicklebleu]

Anyhow, if this helps, great. If there are other things to know or errors here on this subject, I would appreciate the feedback as forewarned is forearmed

I think Yupo might be onto something. It could simply be a matter of financial gain. Maybe they are pushing for it because it's expensive in some countries? I had never heard of those complications, but they make sense, and one should always make sure about hygiene. That said, I know several people who had colonoscopies (including my mother, who had colon cancer at the age of 50 and 53 and that's how they detected it). Nobody I know of has ever had a bad effect from it, and in all those cases, they actually benefited from the study and were able to get some treatment or surgeries in time. Obviously, with a proper diet and a good microbiota nobody SHOULD need this, but at least it's not as invasive as other procedures. Mammographies are known to cause more problems than what they prevent, but I would think that colonoscopies are quite safe.

Colonoscopies are generally safe. However about one in a thousand ends up with a perforated colon, which requires major surgery. Many countries do them under more or less light sedation (which in many cases really is a full anaesthetic under spontaneous breathing). So it's not a totally benigne procedure as such.

What I find shocking is the broad scope of indication, both for gastroscopies (down the throat) or colonoscopies, when the doctor orders such a procedure for complaints as "bloating" or "abdominal pain", without any further testing or assessments or thought about what the issues might be.

I think that this is in part driven by profit, although doctors in public practice don't benefit from that directly (doctors in private practice do, though, and handsomely). It's the whole medical paradigm that is driving that, this unholy alliance between doctors, medical societies, the medical industry and insurance companies. And once the "guidelines" are established by the medical experts, it's risky not to adhere to these, as the doctor might be sued down the line if a cancer develops, which might have been found had the procedure been done at the time. So most doctors just go with the flow.

 

[Yupo]

I would think that colonoscopies are quite safe.

I am aware of several cases that perforated. The women were in poor health anyway. It can be a devastating, complicated injury. 1/1000 can add up to a lot of people if almost everyone over 50 is getting the test. I'd say to be very aware of risk factors going in.

 

[Voyageur]

Re: The subject of colonoscopy

There are some pushes/mandates/arm twisting in USA for physicians to use 'certified' electronic health records (EHRs). There are substantial cash bonuses ($40K/provider) for compliance and pay penalties (progressive percentage pay cuts each year) for non-compliance, as examples. The EHR programs have dinger systems in them to flag any patients not up to date on vaccinations, screening exams, etc. I think these boxes must be ticked to get certification credit for the patient encounter (attestation). I think one has to explain any deviation from the prescribed course to get on with the encounter credit. I say I think, because I am not participating in this program, just watching the stuff as it comes up on the computer screen. At some point soon it will become a requirement to keep records this way.
My best guess is that the increase in screening recommendations is coming from pushes within these systems, based on maybe NIH recommendations.
Also worth noting is that the ACA compliant health insurance policies are big on screening exams. When I had one of these policies, I'd be getting letters and robo-calls very often (at least weekly) about getting some kind of invasive screening I was overdue for.

Interesting. I had a colonoscopy done twice, many, many years apart. After the last one, I was sent several letters weeks apart telling me that I really should have another. I am quite a bit over 50. When I went in for the last one, there were as many men as women there so I think they are targeting everyone. The doctors were quite upset that I didn't want to go in for another. Just like they are upset over me not wanting a mammogram. So what you wrote quite explains it.

As Chu said, that is interesting, Yupo, and these electronic record systems have been mentioned in other contexts. I also get that, indeed, it is a widely practiced procedure and some people have been helped by what was found. Conversely, it is these people who seem fine and are pushed into the procedure with the end result being negative of pathology (oh yeah, nothing was wrong). I was reminded in this regard, that it seemed once the insurer looked at the Cholesterol results one year as being fine and the next year it was not fine, yet nothing had changed with people. It was explained that the bar was lowered, hence more Statins were being prescribed and insurance was going up. So this is why I was wondering if the bar was lowered for some screening issues, such as blood - I mean, people have hemorrhoids, or what have you, that could contribute to an unnecessary procedure when the blood test comes back as a positive.

That's good to know Nienna, the equal men/women thing; I've not been asked yet, so will have to wait and see.

Colonoscopies are generally safe. However about one in a thousand ends up with a perforated colon, which requires major surgery. Many countries do them under more or less light sedation (which in many cases really is a full anaesthetic under spontaneous breathing). So it's not a totally benigne procedure as such.

What I find shocking is the broad scope of indication, both for gastroscopies (down the throat) or colonoscopies, when the doctor orders such a procedure for complaints as "bloating" or "abdominal pain", without any further testing or assessments or thought about what the issues might be.

I think that this is in part driven by profit, although doctors in public practice don't benefit from that directly (doctors in private practice do, though, and handsomely). It's the whole medical paradigm that is driving that, this unholy alliance between doctors, medical societies, the medical industry and insurance companies. And once the "guidelines" are established by the medical experts, it's risky not to adhere to these, as the doctor might be sued down the line if a cancer develops, which might have been found had the procedure been done at the time. So most doctors just go with the flow.

The bolded part seems a constant. It seems rare that one will find a physician that bucks there own systems, yet they are still thankfully out there.

Appreciate everyone's thoughts.

 

[Uperios]

Should You Get a Colonoscopy?​

Story at a glance:

• For those at high risk, colonoscopies may be useful, but it’s important to weigh the potential benefits against the potential harms
• In one study, those who were invited to get colonoscopies had an 18% lower risk of colorectal cancer than the unscreened group, but there was no statistically significant reduction in the risk of death from colorectal cancer
• One analysis found a death rate of 3 per 100,000 colonoscopies, along with serious adverse events in 44 per 10,000, “with a number needed to harm of 225”
• Other risks include bleeding after removal of a precancerous polyp, perforation and anesthesia complications
• To avoid contaminated equipment, contact the clinic or hospital ahead of time to find out about sterilization procedures; you’re looking for a hospital that uses peracetic acid — not glutaraldehyde (Cidex) — to sterilize its flexible endoscopes