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On Having a Colonoscopy: A Holistic Perspective: Back to Articles
by Lauren Feder, M.D.

With a family history of colon cancer and being a certain age, I knew I was a candidate for a routine colonoscopy. Not a big fan of having medical procedures (actually I’m scared), it took me several years to get the courage to schedule the date. Before doing so, I did my research which I share with you in this article:

What is a Colonoscopy?
Colonoscopy is a procedure for detection and prevention of colon cancer. Colon cancer is the second most common cancer in the United States, including 150,000 diagnosed cases a year and 60,000 deaths.  According to GI specialist Dr. Edward Share, “It is virtually the only preventable cancer, because the usual form of colon cancer arises from benign tumors called polyps.”   The current recommendation is for a screening colonoscopy for people age 50 and over, and for people 40 years of age with a family history of colon cancer.   It is recommended that people who have precancerous lesions detected by colonoscopy undergo the test within 3 years, otherwise patients are advised to return every 5-10 years depending on the doctor.

Types of Colonoscopy
Not all colonoscopies are created equal.   There is the standard version in which a long tube (scope) is inserted into the rectum.  At the end of the scope is a camera and light, as well as an instrument used for biopsy. If there is a suspicious lesion such as a polyp, the practitioner can remove it during the exam.  Sedation is usually used, and someone must accompany the patient.  Standard colonoscopy is considered a safe and effective procedure.  Risks include perforation (a hole in the colon), and severe bleeding in up to 1/1000 to 1/3000 cases.

Virtual colonoscopy (VC), also known as CT colonography is an x-ray test using CT scan detection of  abnormal conditions of the colon.  Although both procedures require a day of preparation of cleaning out the colon, VC is less invasive and requires no sedation which means you can drive and resume normal daily activities following the test.    For this procedure, a small tube is placed in the rectum which injects air into the colon for expansion.  Although considered a good test, it is not as accurate as the standard version, because it cannot detect growths 7mm or smaller, and cannot remove polyps.  If polyps are found on VC, standard colonoscopy is recommended.   An additional drawback includes the radiation exposure.

Types of Practitioners
Both family doctors as well as GI (gastrointestinal) specialists can perform the procedure. When choosing a practitioner, consider using a gastroenterologist or rectal specialist/surgeon.  A study showed that colonoscopies performed by an internist or family doctor have higher rates of missing abnormalities including cancer.   Having a colonoscopy in the hospital is preferable over the office, especially if anesthesia is being used.

Sedation
In the U.S., most colonoscopies are performed with sedation. In other parts of the world, no-sedation colonoscopy is used more widely probably due to less expense.  Because of health concerns or medicine sensitivities, not everyone can tolerate the anesthesia, which is short acting.  A colonoscopy without sedation can be uncomfortable, but is tolerated by most patients. In a recent US study only 26 out of 145 people could not tolerate the procedure because of discomfort.  The commonly used medications include propofol, fentanyl, and versed.

Preparation Beforehand
Known as the difficult part of having a colonoscopy, preparation or colon cleansing  with laxatives is important to do the day prior to the procedure in order to properly view the colon.   Although doctors’ recommendations vary with regards to type of laxatives, the goal is the same: to induce a diarrhea so there is nothing left in the colon. Although clear liquids are okay, this day is also combined with fasting.  No food!

Dr. Lauren’s Comments
For a naturally oriented person, cautious about taking medications, undergoing anesthesia and having procedures, the experience was positive and went well. I ultimately chose the standard colonoscopy over the VC, mostly based on the fact that I wanted to avoid x-ray exposure from the CT scan from the VC.

Leading up to the procedure, everyone warned me that the preparation prior to the colonoscopy was the worst part.  So I was prepared.  The weekend before, I went to the grocery store and bought Dulcolax and Miralax as per the doctor’s orders.  Instead of the recommended Gatorade, Sprite, and Chicken bullion I opted for coconut water, homemade chicken broth, electrolyte enhanced water and white grape juice diluted with sparkling water.  

As an experiment (and a gut feeling). I decided to try one Dulcolax tablet several days earlier.  Never having taken laxatives, I thought I would ‘test the waters’ with a small dose beforehand.  Much to my surprise, it was an unpleasant experience!!! In addition to the laxative effect, it caused mild cramping that was reminiscent of early labor in childbirth, as well as vomiting. I knew it would not be good for me to take the recommended dosage on the prep day, I needed another strategy. Speaking with my doctors’ nurse, she told me I could do whatever I wanted as long as I was clean.

After my Dulcolax night of discomfort, I decided to begin fasting earlier than recommended. “The less in, means the less that needs to come out!.”  I fasted 2 days rather than the usual one day.  With all my healthy fluids, I was comfortable and relatively satiated.

Calling upon my holistically minded community with regards to a natural version of laxatives, I asked around and was given several suggestions. I finally opted to use Epsom Salts (Magnesium sulfate) and kept the Miralax as a backup ‘just in case.’ On preparation day, I also decided to stay home rather than go to work.   Instead of starting the doctor’s suggested protocol at 5 pm., I began in mid-morning with an ‘easy-does-it’ approach of 1 tsp. of Epsom Salts mixed with juice. By the end of the day, I had taken the recommended dosage on the box, albeit in small amounts over a longer period of time. I achieved excellent results without  cramps or pain whatsoever. In fact, my prep day was an extremely pleasant day spent at home!  Like a vacation.   Although my doctor never had a patient before who used Epsom Salts, he said it was an excellent preparation. 

Beyond the actual procedure, I learned so much about trusting one’s gut feeling, as well as being able to adapt our natural approach so that we can take advantage of the ‘best of both worlds.’   

Homeopathic Medicine
The following is a list of homeopathic and natural remedies I used (they are not contraindicated before a procedure)

Anticipation: 
    Rescue Remedy, 1 to 2 drops in a beverage, sip as needed.
    Gelsemium 30C (homeopathic), 3 tabs as needed before the procedure
Post-Procedure
   Arnica 30C, 3 tabs twice a day for 2 days (good post-op remedy)
   Ledum palustre 30C, 3 tabs twice a day for 2 days (if a biopsy is done)
Anesthesia Effects
    Phosphorus 30C, 3 tabs once, repeat if needed
Anal Discomfort (if needed for sore bottom or rawness)
   Egyptian Magic topically or any natural cream, such a calendula.
Post-Radiation Effects (after CT scans)
   Radium bromatum 30C, 3 tabs twice a day for 3 days
Epsom Salts
 As with any medication, consult with your doctor before use.

References:
Why Doctors Miss Colon Cancer. http://articles.mercola.com/sites/articles/archive/2007/03/17/why-doctors-miss-colon-cancer.aspx

Magnesium sulfate. http://www.drugs.com/mtm/magnesium-sulfate.html

Epsom Salts as a Laxative  http://www.livestrong.com/epsom-salts-laxative/

Study supports use of no-sedation colonoscopy.  http://www.ama-assn.org/amednews/2009/01/12/hll20112.htm

Colonoscopy every 10 years appears reasonable for low-risk people.  http://latimesblogs.latimes.com/booster_shots/2010/06/colonoscopy-screening-.html

Virtual
Colonoscopy. http://www.ucsfhealth.org/treatments/virtual_colonoscopy/index.html

Dr. David Rosenfeld. http://www.davidrosenfeldmd.com/#!brochures

 
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