Prior to endoscopy, patients are asked to take a bowel preparation as it is necessary to 'clear the system'. However, Prof Owen Epstein and colleagues at the Royal Free Hospital have published a paper that raises serious concerns over the safety of these products. This then naturally raises the question over whether or not is safe for normal, healthy people to be screened for bowel cancer.
Prof Epstein has studied all the papers on this subject and found that there are serious worries about the use of these products. The most commonly reported 'significant events included the following:
- Electrolyte disturbances
- Renal failure
- Colonic ulceration
- Mallory-Weiss tear
- Allergic reactions
He says that it is not possible to know the rates of these side-effects, but that in one year, last year 171 cases of renal failure alone were reported to the FDA.
He reports on two types of product; those containing sodium phosphate (NaP), and a second lot that use polyethylene glycol (PEG). NaP seems to be responsible for a greater number of adverse events, but PEG is also indicated. It is well known that phosphates are toxic - especially in dialysis patients, so it does raise serious questions as to whether these medicines are appropriate for use. Indeed the company C.B. Fleet have issued an immediate product recall and we are still waiting for a response from the other manufacturers.
This raises many questions and we hope to be able to bring you some answers shortly.
