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Page: << Prev | 1 | 2 | 3 | Next >> The procedure involves the insertion of a slender and flexible lighted tube, fitted with a video camera, throughout the entire colon. A sigmoidoscopy relies on a similar but shorter tube to examine just the lower colon. Medication ensures that most patients feel no pain, and the screening is usually conducted on an outpatient basis.
However, patients must refrain from eating solid foods the day before the procedure, while also ingesting a bowel-cleansing liquid to clear out the colon.
The phosphate solution and tablets have been the preparations of preference because of convenience, as they are available without a prescription and require less clear liquid consumption than the polyethylene glycol solution.
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To examine risks associated with use of the phosphate products, the authors analyzed kidney function among 268 patients at their clinic who had undergone either a colonoscopy or sigmoidoscopy between 1998 and 2005.
Most were white, with an average age of 68. Two-thirds were women, and none had a history of kidney disease. All the patients followed a standard dietary and phosphate solution prep the day prior to their screening.
Khurana and his team found that its use was associated with a 6 percent drop in kidney function six months later; that figure rose to 8 percent one year later.
"This magnitude of loss of kidney function is significant," said Khurana, who noted that patients undergo numerous colonoscopies over their lifetime, and normal kidney function loss is confined to about 1 percent per year among patients over 40.
Khurana pointed out that the safety risks he observed might ultimately be the result of patients simply not following manufacturer instructions to drink large amounts of clear liquid when consuming the preparation. Undetected chronic kidney disease among older patients undergoing colonoscopies might also play a role in the findings.
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