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Poor colonoscopy prep hides pre-cancerous polyps
Date:3/27/2012

What happens on the day before a colonoscopy may be just as important as the colon-screening test itself.

Gastroenterologists at Washington University School of Medicine in St. Louis have found that when patients don't adequately prep for the test by cleansing their colons, doctors often can't see potentially dangerous pre-cancerous lesions.

Reporting in the journal Gastrointestinal Endoscopy, the researchers say that doctors often missed at least one pre-cancerous growth in about one-third of patients who did not properly prepare for their colonoscopy. Those polyps and other markers of cancer risk were only discovered months later when patients had their next colonoscopy.

Although several studies have found that up to a quarter of colonoscopy patients don't prepare adequately for the test, the new study is the first to point out the potential consequences of poor bowel preparation in outpatients at average risk.

"Because so many of the patients had a follow-up screening less than a year after the initial test, we strongly suspect that most of the pre-cancerous growths found during the second colonoscopy already were present at the time of the initial test," says first author Reena Chokshi, MD, a gastroenterology fellow at Washington University.

The researchers say their findings suggest that if a physician is having difficulty seeing the colon due to inadequate bowel prep, the colonoscopy should be stopped and rescheduled.

"We often can detect preparation problems during the first few minutes of the procedure," Chokshi says. "And based on this study, we would say that rather than subjecting a patient to the potential risks of a full colonoscopy when we may not be able to detect polyps, or other pre-cancerous growths called adenomas, it may be better to bring that patient back as soon as possible for a repeat procedure with better bowel preparation."

On the day before a colonoscopy exam, peo
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Contact: Jim Dryden
jdryden@wustl.edu
314-286-0110
Washington University School of Medicine
Source:Eurekalert  

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Poor colonoscopy prep hides pre-cancerous polyps
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