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Preparation for Colonoscopy



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NOTE: The Colonoscopy Preparation initial consultation must be scheduled at least 2 weeks prior to your scheduled Colonoscopy procedure date.
Please Call 301-787-1309 for details.

People sometimes avoid a colon cancer screening because they fear the inconvenience of the cleansing preparation more than the colonoscopy itself.

(Colonoscopy is a commonly recommended colorectal cancer screening method. The American Cancer Society states: “Younger adults can develop colorectal cancer, but the chances increase markedly after age 50. More than 9 out of 10 people diagnosed with colorectal cancer are older than 50.” 1 Other risk factors can lower the age at which colorectal cancer screening is recommended.)

Some hospitals are now beginning to offer an alternative method to cleanse the bowel to prepare for a colonoscopy -- one that is more convenient, quicker, and eliminates the dangerous side effects of traditional preparation.

“Patients now have a choice,” said Joseph Fiorito, M.D., chief of the Section of Gastroenterology, a nationally recognized program at Danbury Hospital, the regional medical center and university teaching hospital.

The innovative new method is called colon hydrotherapy, a procedure that infuses warm, filtered, chemical-free water into the colon to cleanse it prior to colonoscopy, a life-saving screening that detects pre-cancerous polyps.

With colon hydrotherapy, patients can avoid the inconvenience and often messy preparation of drinking harsh laxatives the day before the screening. “Some people find the palatability of the liquid unacceptable,” said Dr. Fiorito. “Many people can’t tolerate drinking laxatives to cleanse their colon.”

“Colon hydrotherapy is also much more convenient,” he added. “People don’t have to worry about having to miss work, not eat for 24 hours and stay up all night because of diarrhea.”

Colon cancer survivor Ethel Pancotti of Danbury is one of the people who colon hydrotherapy has greatly helped. She is among those who couldn’t tolerate the laxative process and would suffer loss of electrolytes, eventually passing out and ending up in the Emergency Department.

“With hydrotherapy, there’s no pain or discomfort,” she said. “I was so relaxed that I fell asleep listening to music during the cleansing procedure.”

This procedure is especially beneficial for the elderly, said Dr. Fiorito, who sometimes can’t tolerate the volume of liquid that they need to drink, along with feeling side effects from the laxatives. They’re also more prone to electrolyte abnormalities and kidney damage from the laxative cleansing process.

NOTE: The Colonoscopy Preparation initial consultation must be scheduled at least 2 weeks prior to your scheduled Colonoscopy procedure date.
Please Call 301-787-1309 for details.



MEDICAL STUDY

(The presentation below was taken from the International Association for Colon Hydrotherapy official website.2 )

This study was accepted and delivered as an oral presentation at the American College of Gastroenterology -ACG- Annual Meeting, October 2006. (Only 1% to 2% of all studies submitted, from thousands of abstracts are selected for oral presentation. A testament to how important the ACG feels this topic and research is.)

* Study showed Hydrotherapy was good or better than alternative preparations and patients preferred Hydrotherapy.

* 150 patients evaluated to compare Hydrotherapy to the present standard pre-colonoscopy preparation Methods of Golytely and Fleets Phosphasoda.

Who performed the Medical Study?

Blind Study - Dr. Joseph Fiorito

ACG 2006 : The American College of Gastroenterology Annual Scientific Meeting

Abstract Number : 751814

Primary Author : Joseph Fiorito

Department / Institutev : Gastroenterology, Danbury Hospital

Address : 24 Hospital Ave

City / State / Zip/ Country : Danbury, CT, 06810, United States

Phone : 203-707-7506

Fax : 203-796-7974

E-Mail : joseph.fiorito@danhosp.org

Awards : No Award Selected

Abstract Categories : 11 Endoscopy

Presentation Preference : Either oral or poster only

ACG Research Grant : No

Key Words : Colonoscopy, cathartics, colon preparation.


Title : HYDROTHERAPY COMPARED WITH PEG-ES LAVAGE AND AQUEOUS SODIUM PHOSPHATE AS BOWEL PREPARATION FOR ELECTIVE COLONOSCOPY : A PROSPECTIVE, RANDOMIZED, SINGLE BLINDED TRAIL.

Joseph J. Fiorito, MD, Joan A Culpepper-Morgan, MD, Scott G. Estabrook, MD, Patricia Scofield, LPN, Victor Usatii, MD and Jodi Cuomo, RpH2. Gastroenterology, Danbury Hospital, Danbury, CT United States.

Purpose : Hydrotherapy is a method of colon cleansing using constant warm water lavage using a contained temperature and pressure controlled device administered by a trained technician. The aim of this study was to compare the efficacy and patient acceptance of same – day hydrotherapy (HYDRO) with polyethylene glycol-electrolyte lavage (PEF-ES) and aqueous sodium phosphate (ASP) in patients undergoing elective colonoscopy.


Methods : Consecutive outpatients referred for elective colonoscopy were randomly assigned to receive 4 L PEG-ES (n=55), two doses of aqueous sodium phosphate (n=52), or same day hydrotherapy (n=53), as bowel preparation. The endoscopists were blinded to the method of preparation. The overall quality of the colon cleansing was evaluated with respect to the adequacy of visualization of the right, transverse, and left colon. Patients were asked to rate the preparation with respect to ease, convenience, and comfort using structured, validated questionnaire. Results were analyzed using the chi square test.


Results :

Endoscopists rated the quality of colon cleansing as good:

For the right : 62% ASP,49% PEG-ES,and   92% HYDRO (p<0.001).
For the transverse colon :80% ASP,63% PEG-ES,and 100% HYDRO (p<0.001).
For the left colon: 84% ASP,67% PEG-ES,and   98% HYDRO (p<0.001).

Patients rated the preparations as easy :

87% ASP,    56% PEG-ES,    96% HYDRO (p<0.001).


Patients rated convenience :

61% ASP,    79% PEG-ES,    98% HYDRO (p<0.001).


Patients rated for comfort :

71% ASP,    36% PEG-ES,    94% HYDRO (p<0.001).


Patients were asked if they wanted a different preparation for the next colonoscopy :

48% ASP,    60% PEG-ES,       4% HYDRO (p<0.001).


Conclusion : The quality of colon cleansing, overall tolerance, comfort, and convenience were significantly better for HYDRO. In the study ASP was better than PEG-ES for the same parameters. Hydrotherapy should be further investigates as a viable alternative to PES-Es and ASP for bowel preparation prior to colonoscopy.



What are the Key Points of the Medical Study?

The current business has, as a key foundation, the benefits of a recent medical study.

The study was conducted by Joseph J. Fiorito, MD, FACG, Assistant Clinical Professor of Medicine, Albert Einstein College of Medicine, Chief – Division of Gastroenterology at Danbury Hospital, Connecticut.

The Hydrotherapy Study concluded that using colon cleansing procedures (Hydrotherapy or hydro) were both preferred by patients over chemical preparations and by the doctors who found it less likely that patients were not adequately cleansed for exams and procedures.

The presentation generated a great deal of interest. HydroHealth is recognized as the corporation behind the research. The study was submitted for publication to the American Journal of Gastroenterology and is waiting final acceptance and publishing. Hydrotherapy appears not only cost effective, but may also contribute to revenues for gastro healthcare providers as follows:

1. Increased total numbers of screening procedures due to easier and more acceptable preparation method.

2. Eliminate failed procedures due to “poor prep."

3. Allow increased afternoon procedures due to preparation method with improved results. Hydrotherapy is now being expanded at Danbury Hospital. It is the most requested preparation method when patients are given a choice.

About Danbury Hospital:

Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with New York Medical College, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. It provides centers of excellence in cardiovascular services, cancer, weight-loss surgery, orthopedics, digestive disorders and radiology, with specialized programs for sleep disorders and asthma management. More than 95 percent of the medical staff are board certified in their specialties.

It is ranked in the top 5 percent of hospitals in the country for overall clinical performance by HealthGrades®, an independent health-care rating organization, for 2005 through 2007. In addition, Danbury Hospital is a recognized leader named among the nation’s 100 Top Hospitals® by Solucient, a leading national source of health care business intelligence.

It is No. 1 in Connecticut for overall gastrointestinal (GI) services and only one of seven hospitals in New England to be ranked among the top 5 percent for overall GI services.



References:

1. http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-risk-factors

2. http://www.i-act.org/Resources/Danbury%20Hospital.pdf



Disclaimer: Information on this website is not intended to prescribe, diagnose, or treat a health problem or a disease. It is not a substitute for medical care. If you have or suspect you may have a health problem, you should consult your primary care provider.



 

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