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Colonoscopy risks

Cancer screening via coloscopy can be dangerous

by Healing Cancer Naturally © 2023, Copyright Notice

While recommended to all persons above the age of 50 (in the US, the ACS recommends to begin screening for colon polyps and/or cancer at age 45) and generally portrayed as a harmless preventative screening serving your own good, there are authors who consider coloscopies the most lethal of all forms of cancer screening.

--> The general advisability of screening for cancer in healthy individuals as seen by a professor of medicine has been addressed under Cancer screening in healthy (asymptomatic) people: risks vs. benefits (spoiler alert: he strongly advises against it).

Why would a "routine" coloscopy screening involve the patient with high risks?

Because it is not a simple manual palpation but an examination (sometimes under general anesthesia) where a flexible tube of some 120 cm length is introduced through the anus to which a CCD or fiber optic camera is attached (colonoscope). Travelling along the large intestine, it provides a visual diagnosis (eg shows the presence of polyps, pouches (diverticula), inflammations, infections or cancer.

An invasive procedure such as this can entail enormous risks, and complications are more common than one would suspect (in fact, about 1 in 200 people submitting to a colonoscopy experiences a serious complication).[1]

  • heavy bleeding (2.6 in 1000 procedures - can lead to very serious infections)
  • perforation of the colon and large bowel (1 in 2000 procedures). Generally speaking, this is the most serious complication. It is life-threatening (a digestive perforation which worsens can become fatal) and typically requires immediate major surgery for repair.[2]
  • death (3 in 100,000 procedures)[3]
  • post-inflammatory diverticulitis
  • irritation of the digestive system
  • related risks: anesthesia (increased risk of developing blood clots leading to pulmonary embolism or deep venous thrombosis, in extremely rare cases (preexisting illnesses): heart attack and stroke.
  • related risk: hospital-acquired infection aka nosocomial infection.
  • rare risk: an intracolonic explosion (colonic gas explosion) occurring inside the colon due to ignition of explosive gases such as methane as a result of the electrical nature of the colonoscope. Possible result: acute colonic perforation, which can be fatal.
  • rare risk: splenic rupture
  • Dehydration (loss of electrolytes or dehydration is a potential risk that can even prove deadly.[4] In rare cases, severe dehydration can lead to kidney damage or dysfunction in the form of phosphate nephropathy.[5]

There are other screening techniques which are both much better than coloscopy and much safer. Apparently, Marc S. Micozzi, M.D., Ph.D., has developed 5 screening techniques which could be as efficient as colonoscopy while being risk-free (Micozzi Protocol), including the endoscopic capsule.

Bottom line: it seems advisable, particularly for persons considered low-risk regarding the development of colorectal cancer (due to absence of symptoms and specific risk factors), to weigh the potential benefits of colonoscopy screening against the potential risks of the procedure.

Those who do decide to undergo a colonoscopy might wish to thoroughly read up on the procedure and make sure that all precautions are taken since many of the above risks can be avoided by proper preparation.

Footnotes

1 Complications of colonoscopy in an integrated health care delivery system

2 2013 WSES guidelines for management of intra-abdominal infections

3 Post-Colonoscopy Complications: A Systematic Review, Time Trends, and Meta-Analysis of Population-Based Studies

4 http://www.journey-with-crohns-disease.com/colonoscopy-risks.html

5 Is bowel preparation before colonoscopy a risky business for the kidney?

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