No one is looking forward to a colonoscopy. This observation of the interior of the large intestine is even rather dreaded, in particular because of the rather demanding preparation: Several decades ago, patients first had to cleanse their colon with laxatives like castor oil for several days. Very unpleasant. Since last year, the preparation for the screening colorectal cancer may still be less painful thanks to new pills, we learn le Washington Post.
In 1984, the Golytely treatment entered the medical scene. This disgustingly tasting powder for oral solution allowed patients to pass “three days of torture [avant une coloscopie, ndlr] at half past three”, explains gastroenterologist Jack Di Palma, professor at the University of Medicine of Alabama, to the American daily. But this cleansing treatment the intestine had to be drunk in large quantities: more than four liters of foul-tasting liquid.
Many doctors tried to give some advice to their patients to make it easier to swallow, such as “swallow the solution with a straw, hold your nose, chew gum [entre plusieurs gorgées]»explains Louis Korman, a gastroenterologist in the Washington DC area “Everyone hears anecdotes about this horrible preparation. Everyone remembers it and it is unfortunately a deterrent for colonoscopy.”
Screening needed
The validation, in 2021, of a new preparation by the Food and Drug Administration (FDA, the American food and drug agency) is therefore very good news for patients. This new solution called Sutab works just as good as the previous one, but without the awful taste. The twenty-four pill pack allows patients “for whom taste is a real difficulty” to no longer apprehend the detection of cancer colorectal. Twelve pills must be taken the day before, then twelve on D-Day, a few hours before the examination.
If this preparation for the colonoscopy remains unpleasant, it is nevertheless essential and necessary for the intervention of the doctor, since its objective is to completely empty the intestine of its contents. During the examthe doctor introduces a flexible tube, on the end of which is a camera, which winds this part of the digestive tract in order to detect any benign tumor and to remove the polyps, precursory signs of cancer of the colon. This is by far the best way to detect this type of cancer.
While until recently guidelines recommended people over 50 and at high risk get screened, the American Cancer Society is now urging anyone over 45 at moderate risk take the plunge and make an appointment for a colonoscopy.
Alternatives to internal colonoscopy do exist, however, such as screenings to be carried out at home through a stool sample. However, as Duke University oncologist Arif Kamal explains, “the operation must be repeated every two to three years, compared to seven to ten years for an internal colonoscopy”.
According Public health France, “Colorectal cancer is one of the most common cancers (third in men and second in women) and represents the second leading cause of cancer death”. Note before getting tested in France: for the moment, the Sutab solution is not marketed in France.