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Is colonoscopy worth the risk?

Colonoscopy is a procedure done to check the abnormalities of the colon and rectum by visual examination using a colonoscope. A colonoscope is a flexible, long and tubular device equipped with a fiber-optic camera which is pushed inside your rectum and using that, the whole examination of the lower gastrointestinal area can be done. Patients suffering from different digestive disorders are mostly advised to get it done from a professional doctor. It may also be used for diagnosis of other diseases and conditions too, like

  • Abdominal pain
  • Screen for colon cancer
  • Blood in the stool
  • Unexplained weight loss
  • Inflammatory Bowel Disease (IBD)
  • Anemia (low red blood cells)
  • Trichuris trichiura Infection
  • Change in bowel habits

Though its a quite safe procedure, many of the patients may get in a dilemma of opting for it or not. taking account of that skeptical side of yours, here are various facts that help you in deciding whether the risks of colonoscopy are worth the expected benefits.

Perforation

Perforation, i.e., tear or hole in intestine, is the most feared complication of colonoscopy. Colonic perforation may result from mechanical forces against the bowel wall, barotrauma, or as a direct result of therapy or tissue sampling. During diagnosis the risk of getting a perforation due to colonoscopy is much lesser than during the treatment or polypectomy.

A perforation is said to happen when an instrument or device punctures a thinner area in the colon wall. It may also be caused due to excessive distention by introduction of air in colon. The rate of perforation may not differ all that much for diagnostic colonoscopy and colonoscopy with polypectomy, and is estimated to occur at 0.1 to 0.3 percent.

If the perforation is large and visible enough to be a threat, a surgery is most preferred option by doctors to sew-up or close the tear. For comparatively smaller sized tears and punctures, surgery isn’t required and the treatment can be done with antibiotics, bowel rest, and careful monitoring.

Bleeding

Colonoscopy-related bleeding happens because of the mucosal lacerations (wound or cut in the esophagus lining) due to the colonoscope. Bleeding is the most common side-effects faced in colonoscopy even though it occurs in about one per thousand colonoscopic instances.

Treatment of the bleeding can be done during the test, but in most of the cases, it is left to heal up on its own. When a polyp (abnormal tissue growth) is cut out using polypectomy, a possibility of 30 to 50 percent is expected for bleeding to occur anywhere from 2 days to a week after doing the colonoscopy. Treatment is essentially required in cases where the lacerations are severe.

Postploypectomy Burn Syndrome

Postpolypectomy coagulation or transmural burn syndrome results from electro-surgical thermal injury during the removal of a polyp, that extends to the serosal surface of the colon without any actual perforation. The postpolypectomy burn syndrome occurs following 0.5% to 1 percent of polypectomies, and is usually seen 1 to 5 days after resection of large (2 cm), sessile polyps in the ascending colon.

A person may develop fever in about a couple of days after being treated by colonoscopic polypectomy. Other such postoperative symptoms include nausea, pain in abdomen region, and a high WBC (leukocytes) count. If dealt carefully, the risk of postpolypectomy syndrome after a colonoscopic polypectomy reduces down to nil. Treatments suggested for the syndrome may include rest, intravenous fluids, and prescribed antibiotics.

Adverse effects of Anesthetic Medications

Sedatives like anesthesia given just before the operation are given to make the operations of colonoscopy and polypectomy pain-free make patients more comfortable. But there are postoperative complications related to these sedatives, such as slowing down or complete shutdown of gastrointestinal peristalsis which further causes severe dyspepsia, allergic reactions, food poisoning, serious respiratory problems.

Some other risks which may arise due to anesthetics include a reaction over the area where an injection is given, vomiting, nausea, and hypotension.These risks and conditions are often exacerbated by quickly resuming to the usual diet (i.e. solid food).

Colonoscopies Destroy Bacterial Flora

The really worrying side-effect of this type of cleansing through colonoscopy is the destruction of your bacterial flora and imbalances the count of microorganisms on inner linings of your colon. An average colon may contain 3 to 4 pounds of bacteria. If you are fit and healthy, most of that count consists of good, healthy bacteria. Colonoscopy and polypectomy procedures strip off the lining of colon of its protective layer of bacteria thereby exposing it to various other secondary risks or opportunistic infections by pathogenic bacteria, viruses etc.

Thus, when the colonoscope is inserted into the colon, it makes the situation highly vulnerable and exposed to various threats. What most of the people who are familiar with colonoscopy don’t know is that its not possible to completely and properly sterilize the devices.

Increased cancer risk from radiation and dysbiosis

Even a one time exposure to X-rays from a virtual colonoscopy raises the risk for a patient’s cancer development in his lifetime by 20 percent. Virtual colonoscopies are currently being recommended for once every 5 years. By the time you reach an age of 70, the risk of developing a cancer of different form grows to whopping 100 percent! Thus, the treatment and diagnosis of colon related polyps or colon-cancer by a colonoscopy makes you highly prone to other types of cancers too.

Another way by which one may get affected in a carcenogenic way is the damage of intestinal bacteria by using colonoscopy, which is also called as disbacteriosis (dysbiosis). It causes irregularities, constipation, diverticular disease, nausea, diarrhea, bowel syndrome, and other inflammatory bowel diseases. Some inflammatory bowel diseases including ulcerative colitis and Crohn’s disease are very well known to raise the risk of the colon cancer up to 32 times.

Increased risk of pulmonary embolisms,deferred strokes and cardiac arrests

Further risks of colonoscopy includes many unreported medical errors and deferred side effects, such as severe anemia which could be caused by blood loss, pulmonary embolism (blockage of main artery) , cardiac arrests, or stroke related to blood clots caused by general anesthesia. One must take into account the risk of blood clotting, a common side effect of anesthesia, and is seen particularly among diabetic and heart patients.

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