BOWEL CANCER is the second most common cause of cancer death in Australia.
Colonoscopy is by far the best currently available tool for screening, prevention, early detection & surveillance of Bowel Cancer. Research shows that less than 50% of people 50 years of age or older are adequately screened for bowel cancer. Surveys of patients & clinicians show that Oral Bowel Preparation is by far the most objectionable aspect of a colonoscopy.
ORAL BOWEL PREPARATION (e.g. Picoprep) has the potential to cause significant adverse reactions in more than two thirds of patients. These include abdominal pain, cramping, bloating, nausea, vomiting, anal pain, sleep disturbances & dizziness. This also often results in failure to complete the preparation which increases the risks of the procedure, the likelihood of missing polyps or cancer & often the need to repeat the colonoscopy. Oral Preparation can also be unsafe. Serious complications include dehydration (fluid depletion) or water retention (water intoxication) with significant electrolyte imbalance especially in patients with any kidney, heart, liver or other diseases; keeping in mind that at least 25% of adults 70 years of age or older have at least moderately decreased kidney functions. Other reported serious complications include arrhythmias (e.g. atrial fibrillation), falls & injuries, renal failure, seizures, drug interactions, pill malabsorption, hypothermia, ischaemic & toxic colitis, oesophageal tear or perforation, aspiration pneumonia & acute pancreatitis. In the USA, one to two individuals die from Oral Preparation on average per year.
The Alternative is RETROGRADE BOWEL PREPARATION, also known as RetroPrep™. Retrograde Preparation is based on a TGA & FDA approved safe & effective outpatient procedure currently used at a number of centres in Sydney, Melbourne & elsewhere, that eliminates the need to drink the Oral Preparation. Other than the standard pre-colonoscopy diet and mild laxatives, the main preparation is a 1 hour colonic washout that is performed at the medical facility using double filtered purified warm water through a Canadian system. It is administered by one of our registered nurses or trained practitioners.
Special considerations include active inflammatory bowel disease, severe haemorrhoids, anal fissure or fistula, a large hernia & severe cardiac, renal or liver disease. RetroPrep™ is not safe in suspected bowel obstruction or perforation, pregnancy & recent large bowel surgery. There has been a very small number of reports of electrolyte imbalance mainly low serum potassium.
RetroPrep™ is an effective form of bowel preparation for colonoscopy that is safer and better tolerated than standard oral bowel preparation.