The little-discussed risks and side effects of colonoscopy screening and why, in some cases, people would do best to avoid them. If you must have one, how to minimize the dangers as much as possible and a safe alternative to consider as a logical middle ground.
March is National Colon Cancer Awareness Month each year. At that time, the usual health experts trot out on TV and print media to urge us all to get a colonoscopy. The inherent risks of this reviled procedure especially for those over age 50 are usually conveniently glossed over in favor of an aggressive push about the benefits.
That “kick in the butt” might initially sound like a good idea. However, according to the Annals of Internal Medicine, the rate of serious complications from colonoscopy screening is ten times higher than any other commonly used cancer-screening test.
According to Konstantin Monastyrky, author of Fiber Menace:
The odds of being killed or injured by the side effects of colonoscopy may exceed your odds of getting colorectal cancer in the first place.
He further points out that the procedure is far from infallible. It often fails to catch colorectal cancer in the first place. In addition, it can cause, contribute to or accelerate the growth of colorectal and other cancers.
Let’s go into each of these colonoscopy risks in detail.
Dysbiosis
Intestinal flora is disrupted by a colonoscopy because the procedure requires a thorough washing out of the large intestine with large doses of synthetic laxatives. This is followed by bowel irrigation with polyethylene glycol and hypertonic electrolytes.
These substances kill bacteria, both good and bad just like antibiotics. The gut dysbiosis that inevitably follows contributes to irregularity, constipation, colitis, IBS, Crohn’s, and other diseases known to increase colon cancer risk. Dysbiosis also contributes to a wide range of other autoimmune health problems.
Worsening of Stool Patterns
Those already affected by hemorrhoids, chronic constipation, IBS, or diverticulosis may find these conditions become worse after colonoscopy.
Complications
Serious complications, such as colon perforation, occur in five out of every one thousand colonoscopies.
The risks of delayed bleeding, infection, and ulceration are even higher. Unfortunately, reporting of these complications in connection with colonoscopy is rare.
Increased Risks of Stroke, Heart Attack, and Pulmonary Embolisms
Dangerous blood clotting is a side effect of anesthesia, particularly among patients with diabetes or heart disease.
Infections
Procedures performed under anesthesia are associated with an increased risk of serious infections. This includes pneumonia or pyelonephritis.
False Sense of Security
Doctors miss from 15-27 percent of polyps, including six percent of large tumors. The New England Journal of Medicine even reported that some doctors blast through the colonoscopy so fast they miss cancer in full bloom!
Indeed, the desire for speed is why most colonoscopies today are done under anesthesia. Might there be a profit motive? Some doctors do 60 colonoscopies per day at an average cost of $1,500 to $2000 each. You do the math.
Colonoscopy Alternative
Many people do not realize that you can order an at-home colorectal screening kit to avoid most colonoscopies. They are inexpensive, safe, and convenient. Blood, polyps, and other abnormalities are quickly detected by using a simple stool sample. Results are available fast with lab accurate results.
If you have a positive result from one of these home tests, then go get a colonoscopy. But, in most cases, you will get a negative result, saving you the discomfort and risks of the actual colorectal screening.
Ways to Manage Colonoscopy Risks
Here are a few suggestions about how to increase the level of safety and accuracy in the screening for colon cancer.
- Those with a family history of colon cancer or otherwise at high risk probably should do a colonoscopy. But it is best to request to have it done without general anesthesia. That’s where the majority of the risks are. Some doctors offer inhalation sedation as a safer alternative. Doctors who prefer knocking the patient out use this approach so they can ‘jam’ through the colon much faster. Billing for anesthesiology increases revenues for the hospital too.
- Doing radiography first is pointless. The reason? If they find some polyps, you will still need to have a colonoscopy. Besides, you don’t want all that huge exposure to ionizing radiation.
- If you do decide to go through with a colonoscopy, at least prepare with clear broth you make yourself. Commercial brands at the store are not nutritious and contain unhealthy additives and MSG. Exposure to these chemicals can potentially make digestive issues worse and recovery more difficult.
- After the colonoscopy, follow this protocol to rebuild gut flora. It is the same process recommended by experts after a round of antibiotics.
There are times when the procedure is necessary. My husband is a good example – he is now 40, and gets screened regularly since his 20’s as his mother died when she was 38 with colon cancer. She died only 3 months after detection.
Everyone being screened? Probably not necessary considering the risks. But those who are at high-risk, it can save lives. Benefits vs. risks.
Well said.
I’ve had multiple colonoscopies due to ulcerative colitis…there just isn’t a better way to monitor the disease. I’ve never had a doctor use general anesthesia nor had any complications (choose your doctor wisely!). You make a good point to make sure you work on keeping your gut healthy. Sometimes, as the previous poster with a family history of colon cancer affirms, some of us do need colonoscopies. We should be careful in who we choose and how we care for our bodies before and after the procedure.
@Crazy4boys: Please don’t confuse “diagnostic colonoscopies” of people with chronic or life-threatening conditions, such as internal bleeding or ulcerative colitis, with “screening colonoscopies” for healthy people.
That is what Dr. Daniel’s post is all about: the high risk of colonoscopy screenings among healthy, non-symptomatic people in a low risk group for colorectal cancer.
I don’t feel like I did confuse them. The tone of the article, however, is such that some persons who might need a colonoscopy and should get one, will be scared away from them. It’s important to know the risks, as mentioned by the doctor, but sometimes they are necessary.
I agree. My father had rectal ca at 55 so I will continue to get regular colonoscopies every 3-5 years. I don’t think we should scare people off from having the procedure when warranted but also agree that an article about replacing gut flora would be a good match here.
I didn’t even know healthy people had screening colonoscopies… crazy!
It is my understanding that if you already have an established issue such as ulcerative colitis, crohn’s, etc. that at home tests are not a good indicator of whether there is a more significant problem and are not recommended for those with existing conditions. I have ulcerative colitis too and that was the information my research led me to. I have been putting off getting my overdue colonoscopy because the first time I did it was miserable and it required 2 full days of prepping since only 1 day was not enough. And the office treated me like I must not have followed the instructions (I had).
My friend got perfed, they had to immediately remove a foot of his intestines. What did he get from it? a foot long scar on his stomach and weeks of pain. Stoopid procedure!
Thanks for the article. My husband is scheduled to get one later this month. He might change his mind after reading this.
Every invasive procedure like this has risks. Thank you for this article, as most doctors gloss over the risks as if there weren’t really any at all. If you haven’t done one, I’d love to see a blog post on how to restore your intestinal flora after the destructive cleansing that needs to happen before a colonoscopy. I’ve had two – both necessary, in my opinion – but I know I messed up my intestinal health in the process.
I too would like to see a post on how to restore normal intestinal flora post-procedure.
I had to endure 2 different prep days because the first doctor’ office gave me the boot after I complained about being made to wait all morning and part of the afternoon for my “appointment.” They said perhaps I could find someone else in town that could do it for me that day. What jerks. I went to the larger clinic in town the next week to have it done (that’s why I had to do another prep). My stomach problems began after these 2 preps. I finally went to a naturopathic doctor. He told my I had dysbiosis and prescribed a slew of digestive enzymes and whole food vitamins. I was in tough shape. I feel so much better now. Never again will I go through that experience.
I had a colonoscopy at age 25 for IBS with a family history of colon cancer. I went to an old school doctor, not knowing any better. I was out for the procedure but woke up when the scope turned and cried out in pain. He gave me more sedation. It took a long time to come too and the dr kept checking in me knowing he gave me way too much. It was awful. The prep is the worst part. Can’t be good for the body. I never want another!
I have digestive disease, and I believe the last one almost killed me from blood loss and the side effects of the solution your are supposed to drink. I then spend a whole year on their drugs because everything worsened significantly after the proceedure. After continuing to get my blood work and researching what these drugs were doing to me (which include cancer and other risks), I weaned myself off the meds against their wishes and continued to utilize them for bood testing until I did. Once I had completely weaned, I never went back. I spent the next year and a half healing myself…I do still have digestive disease. I don’t believe I will ever truly be cured. However, apart from flare ups that happened due to hormonal balances after the births of my two children, I am largely symptom free and consider myself in remission for the most part. I will never have a colonoscopy again unless there is a clear indication for doing so. I truly believe the risks outweigh the benefits, in many cases, especially in cases like mine which could be treated with good (not conventional) nutrition, probiotics, and patience. I am glad that the more extreme things exist for those who truly need them, but I do wonder how much digestive disease could be avoided in general by eating intelligently and avoiding processed foods.
Short chain fatty acids, 2 to 6 carbons, lower #colon pH (raises acidity) which protects from formation of #polyps. http://t.co/ur7ZELHA
Cancerclasses, I don’t do Twitter. Do you have a website or blog?
With a first degree relative (my dad)diagnosed when his colon cancer was already stage IV, refusing wasn’t an option for me–my dad died just a little over a year after diagnosis. I dreaded my first colonoscopy terribly but it wasn’t as horrible as I imagined.
On the all liquids day I had plenty of my homemade kefir and homemade bone broth on both prep days. I drank electrolyte water instead of sugary Gatorade for the prep. I didn’t have any side effects from the process and my gut seemed none the worse for it. Yes, there are risks, but this is one cancer that CAN be treated early with good results.
Dear Kaayla and Sara,
Thank you very much for sharing this important information on your blog. I’ll be monitoring this comment section, and welcome questions from your readers!
Konstantin Monastyrsky, the author of Fiber Menace
I have had a positive stool test. Blood was found, but could it be a false positive? And since I have GERD and diverticulitis could the blood, if in fact there, be coming from those other conditions. I am 60 years old. I prefer alternative treatments not the invasive traditional ones. What do you suggest? I am being pushed toward the colonoscopy. Should I do a thermogram of the abdomen instead?
I had a lipoma that was found during a colonoscopy. It was just inside the small intestine and I had no symptoms. If it hadn’t been found it would have eventually blocked the Ileocecal valve. I am glad I had the procedure.