Colonoscopy prep products MAY trigger MC

[Zizzle]

Apologies if this has been discussed recently, but now that we're talking about getting less than the recommended number of colonoscopies, does anyone know what our actual risk of colon cancer is? I know the literature says we are not at increased risk of developing it becuase of MC, but the general population risk is not great either. I've always thought of colon cancer happening to constipated processed meat-eating types, who retain toxic fecal matter for longer than recommended. Could our constant flushing out be protective in any way? Could our lymphocytic infiltration be on such high alert that it destroys early cancer cells too? Or is inflammation always a risk factor for cancer, no matter the type?

[grannyh]

Interesting thought.. that our illness cleans us out.

I think we each have to look at our own family history to decide about our potential risk of colon cancer. For what it is worth, my GI doc says every 10 years.. UNLESS there is a family history of cancer or they find a problem when the do the first colonoscopy. He told me early on that many doctors do them on a more regular basis because they are an "easy money maker" for GI docs. He has other things he finds more fascinating to do as well as vast referrals to fix other doctors' mistakes of various types.
grannyh

[tex]

Could our constant flushing out be protective in any way? Could our lymphocytic infiltration be on such high alert that it destroys early cancer cells too? Or is inflammation always a risk factor for cancer, no matter the type?

Interesting questions. Diarrhea is definitely invoked by the body, to serve a purpose - namely, to get whatever irritating agents might be present, out of the system, as quickly as possible. I presume that our basic defense against tumor cells lies in Natural Killer T-cells, (NKT-cells), which seek them out and destroy them, on the basis that they do not have the markers of "self".

They're also our primary defense against viruses, as they destroy cells that have been infected by viruses. MC is a T-cell reaction, and I'm guessing, (though that's just a guess), that natural killer T-cells are also involved. If they were not, how could reactions of this type, (to certain foods, etc.), be considered to be an autoimmune reaction?

On the other hand, macrophages can actually promote tumor growth, but macrophages are not generally associated with MC reactions.

Sooooooooooooooo, I would say that it certainly might be possible that the increased presence of NKT-cells could help to suppress cancer cell development. The downside is that increased inflammation is generally an undesirable state, since it can cause all sorts of issues, in various organs of the body. I have no idea how these contradictory conditions relate to each other, or if one "trumps" the other.

Incidentally, prior to my colectomy, I was one of those "constipated processed meat-eating types, who retain toxic fecal matter for longer than recommended." Even when my MC symptoms presented, I alternated between D and C, with C prevailing prior to that, including markers such as diverticulosis/diverticulitis. When my MC symptoms began, (D that wouldn't stop), I was immediately diagnosed with colon cancer, by my GP, and by the GI specialist that he sent me to, but all the test results were negative. 5 years later, when I had to have surgery to remove a stenosis in my sigmoid colon, because it caused a blockage, my doctors all assumed that cancer was the problem, again, but the pathology report was negative - the "mass" was benign. Current research shows no relationship between eating red meat and the incidence of colon cancer.

Tex

[Barbi5055]

Hmm. Because I have a family history of Colon Cancer, I've been getting "routine" Colonoscopies since the age of 25....maybe you're onto something.

Thank you.

[Barbi5055]

Zizzle, My GI has told me that there is no increased chance of Colon Cancer with LC...does anyone else have information to the contrary?

I can't help but wonder about the correlation between my disease (LC) and my Mother's, Brother's and Grandfather's Digestive Cancers??

[wonderwoman]

I had a sister 72, and a niece 50, die from colon cancer. As a result I have had three colonoscopies. First two were routine and almost 5 years apart. The last one was 11 months after the second one due to extreme D. That was almost a year ago and I was diagnosed with CC at that time.

[MBombardier]

I found this quote at the end of the U Mich article that Tex posted:

However, this design does not control for variables that change over time, including the subjects’ self adjustment of their medication dosing. We did not expect to see frequent self-adjustment of 5-ASA medication dosing by subjects without consulting their gastroenterologists, but this clearly occurs and may confound the results of this and other clinical studies.

Bad patients, b-a-a-a-d patients! That's one reason I am not looking forward to seeing my GI next week--I did not take the Apriso that he prescribed for more than a couple of weeks.

[Robbie]

grannyh, I think there is something to what he says. I had chronic constipation and poop attacks all of my life, long before my first colonoscopy. I got my first scope ten years ago because of a positive routine home stool test. It flipped me to chronic D. I have always believed the scope or the prep wrecked me because I had left-sided cramping during the prep and every single day afterwards for at least five years. It gradually started getting better and I only had it about half the time. Till I got ecoli four years ago, which, of course, made everything worse. I finally decided to see a doctor when I passed blood and the D was daily, all day long, but it was getting out of control way before that. I truly-uly think the root of my problems going from being a real drag to practically ruining my life was the day I got that first scope. And to think - I went ahead and did it again. I swore to myself for ten years I never would, but I freaked when I passed blood. I am back to telling myself every day that I will NEVER get another scope.......

BTW, one of the first things I told the scope doctor who diagnosed me with UC, when I went in for my biopsy results two weeks later, was how much worse I got after the scope. When I realized dairy was making me worse than ever in my life I stopped all dairy and saw immediate improvement for about two or three weeks before the scope. Then I was right back to square one as soon as I had the procedure. Because my pathology report was "mild, chronic colitis" my doctor blamed whatever it was the the scope doctor thought was UC on the prep. I believe she is correct. But.....who really knows. I don't have a clear cut case of LC, from what I can tell, but Tex says the markers are there. I don't have UC from what I can tell, based on all the stuff I've read. But something, whatever it is, looks fairly gross in the pictures

Sorry if my post is not making sense. It's way past time to log off and go to bed.........

[grannyh]

You can take it to the bank that "chronic colitis" and "IBS" are diagnosis that mean "I don't know". They are catch all phrases that are supposed to make you feel like you have a diagnosis.. then the doctors can "try" all kinds of things on you that probably won't work..like high fiber and drink more water...LOL Not to mention the various powders and potents they prescribe that make it worse.

One thing this site provides is hope and encouragement that if you keep at it.. things can get better.. MOST doctors don't have any success with patients.. mine does..
grannyh

[TooManyHats]

I took something called Suprep Bowel Prep Kit. I COULD NOT drink it all. Drank the entire first dose (and should have stopped there) and about 1/2 to 1/3 of the second dose. I felt so guilty like I had cheated. One of the reasons that I had been avoiding a colonoscopy was my tendency towards D. I can't say it made it worse, but it didn't make it any better. I kept saying the prep was worse than the procedure and that I won't be doing that again. I wonder whether this made the inflammation worse for the biopsies? Or am I over thinking this?

As a side note, I spoke to my Mother In Law (84) who's Sister In Law had colitis. Her diarrhea never relented and eventually had to have a colostomy. She was amazed that I wasn't following my doctor's advise and cannot fathom that diet is helping me. She has never heard of anyone (who the one person she knew?) that had their D stop after this diagnosis. By the end of the conversation I was just "yes-ing" her to death so I could get off the phone. The only part of her advise I may take is to try to find another GI doctor.

[tex]

I wonder whether this made the inflammation worse for the biopsies? Or am I over thinking this?

I've seen reports where GI docs suspected that, and requested a followup colonoscopy exam, using a different cleanout solution, but unfortunately, I can't recall where I read that, and I don't recall which prep they were referring to. I have a hunch, though, that once the inflammation is triggered, a subsequent cleanout and colonoscopy exam are a moot point, because once triggered, the inflammation may very likely continue to propagate on it's own.

One of the worst problems with the prep solutions, (IMO), is the fact that they are used as a "one-size-fits-all" treatment. It doesn't matter if the patient weighs 100 lbs, or 400, the quantity is the same. Unfortunately, that's also the case with most prescription meds used for humans. Any vet will tell you that that's not the way to administer the use of drugs. Vets determine the dosage based on the body weight of the patient. It's a shame that human docs aren't well enough acquainted with simple math to be able to do that. Instead, they overdose smaller patients, and underdose larger patients. If they specified a correct minimal dose of prep solution, prior to colonoscopy exams, that might help to cut down on the number of adverse reactions to it, which result in treatment-related MC.

Tex

[Gloria]

One of the worst problems with the prep solutions, (IMO), is the fact that they are used as a "one-size-fits-all" treatment. It doesn't matter if the patient weighs 100 lbs, or 400, the quantity is the same. Unfortunately, that's also the case with most prescription meds used for humans.

I've often thought about that. DH weighs twice as much as I do, but the dosages of supplements, medications, etc. that we we take is the same.

Gloria

[Polly]

Tex and Gloria,

I couldn't agree more. In fact, it is one of my major rants! But Tex, some human docs do calculate dose based upon weight - PEDIATRICIANS. Ta Daaaaa.

Love,

Polly

[grannyh]

I asked about the prep being the same for all people...years ago. The response.. Well most people don't take all of the prep so we just make sure there is enough to clean everyone out! How's that for dumb! Wish I wasn't a rule follower.. I would have stopped at 4 or 8 visicol pills..instead of all 28.. might not have triggered the colitis..but will never know for sure.
grannyh

[tex]

But Tex, some human docs do calculate dose based upon weight - PEDIATRICIANS. Ta Daaaaa.

I started to add a note about that exception, but I was afraid that it might detract from my attempt at sensationalism.

Seriously, I really do feel that it's a shame that other doctors don't bother to do that. For one thing, because of that policy, it's almost certain that labeled doses for meds are developed with that in mind, (one-size-fits-all), rather than being developed so that doctors could prescribe more accurate doses for individual patients.

In fact, I'll bet a GF cookie that this policy was established by the pharmaceutical industry, rather than by the medical community. Am I wrong? At any rate, I don't see any new meds coming to market with label stipulations for the prescribing doctor to determine the dosage rate based on patient characteristics, (except for pediatric use, of course. )

Love,
Tex