Concerns over screening for bowel cancer

Prior to endoscopy, patients are asked to take a bowel preparation as it is necessary to 'clear the system'. However, Prof Owen Epstein and colleagues at the Royal Free Hospital have published a paper that raises serious concerns over the safety of these products. This then naturally raises the question over whether or not is safe for normal, healthy people to be screened for bowel cancer.

Prof Epstein has studied all the papers on this subject and found that there are serious worries about the use of these products. The most commonly reported 'significant events included the following:

  • Electrolyte disturbances
  • Renal failure
  • Colonic ulceration
  • Mallory-Weiss tear
  • Allergic reactions

He says that it is not possible to know the rates of these side-effects, but that in one year, last year 171 cases of renal failure alone were reported to the FDA.

He reports on two types of product; those containing sodium phosphate (NaP), and a second lot that use polyethylene glycol (PEG). NaP seems to be responsible for a greater number of adverse events, but PEG is also indicated. It is well known that phosphates are toxic - especially in dialysis patients,  so it does raise serious questions as to whether these medicines are appropriate for use. Indeed the company C.B. Fleet have issued an immediate product recall and we are still waiting for a response from the other manufacturers.

This raises many questions and we hope to be able to bring you some answers shortly.
 

A common name for the large and/or small intestines. Full medical glossary
Abnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
Examination of the inside of the body using a tube equipped with a light source and either a small camera or an optical system. Full medical glossary
pulmonary embolism Full medical glossary
Salts that are essential in the diet. Full medical glossary
Relating to the kidney. Full medical glossary
One of the chemical components of salt (sodium chloride) and an important blood chemical. Full medical glossary
Any abnormal break in the epithelium, the outer layer of cells covering the open surfaces of the body. Full medical glossary
The presence or formation of an ulcer - an abnormal break in epithelium, the outer layer of cells covering the open surfaces of the body. Full medical glossary