I often write about the many dangers of colonoscopy as a screening technique for colon cancer.
It’s portrayed as a benign, safe procedure and commonly accepted as a necessary preventative screening as we age. But in my forensic medicine practice, I saw case after case of perforated intestines and peritonitis, a potentially fatal inflammation of the abdominal lining. I also saw lacerated and punctured livers with massive bleeding and shock, and other fatal complications. All from “routine” colonoscopies.
Perhaps it’s not so surprising that a new study revealed that patients with inflammatory bowel disease (IBD) — a common GI condition that includes Crohn’s disease and ulcerative colitis — had significantly more complications than patients without the condition. And the complications were dangerous, often requiring hospitalization or emergency room visits following the colonoscopy.
Ironically, doctors commonly order colonoscopies for patients with IBD to help with diagnosis, evaluation, management, and treatment of the condition. But, as the new study shows, it can cause more harm than good.
Patients with IBD more likely to require hospitalization
For this study, researchers with Johns Hopkins University in Baltimore analyzed data for 36,175 patients with IBD and compared it to 1,340,501 patients without IDB.
For seven days following a colonoscopy, patients with ulcerative colitis had a 30 percent higher rate of complications requiring hospitalization than patients without IBD. Patients with ulcerative colitis also had increased risks of perforation and sepsis, and high risks of blood infections.
And patients with Crohn’s disease fared even worse. They had a 60 percent higher rate of complications requiring hospitalization. Plus, patients with Crohn’s disease had a 3.7 times higher risk of suffering a colonic perforation, 2.6 times higher risk of sepsis (systemic blood infection), and 2.3 times higher risk of other infections following colonoscopy, as compared to patients without IBD.
Furthermore, the difficult-to-treat, hospital-acquired infection Clostridium difficile was seven times more common in patients with Crohn’s disease and 13 times more common in patients with ulcerative colitis, comparatively, even after excluding patients with pre-existing conditions.
A few other factors influenced complication risks…
- Patients who had been hospitalized within 30 days prior to colonoscopy had nearly five times the rate of complications.
- Patients who’d had an endoscopic procedure within 30 days prior to colonoscopy suffered more than double the rate of complications.
These kinds of striking findings suggest that the colonoscopy procedure itself is the source of these deadly infections, as I’ve reported previously.
Lead researcher Dr. Peiqi Wang stated, “The implication is that most of the time, people just think that colonoscopy doesn’t do any harm…that it helps you diagnose or understand the disease. But in some circumstances, there could be better timing.”
Of course, you know, dear reader, about the dangers of colonoscopy — even under perfect conditions with the best timing!
To his credit, Dr. Wang admitted that substituting colonoscopy with non-invasive tests would be beneficial. Especially for those with IBD.
Always consider these alternatives first…
As I often report, a number of safe, alternative screening procedures are just as effective as — or even more than — colonoscopies for screening for colon cancer.
Unfortunately, you aren’t likely to hear about these alternatives from your own physician anytime soon.
Spaces for this summit are filling up fast, so I urge you to click here to reserve yours now, while there are still some available.
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Abstract P-016. Presented at: Advances in IBD; Nov. 9-11, 2017; Orlando, Fla.