Wednesday, April 24, 2024

Colonoscopy Research

Environmental & Science Education, STEM, Health, Medicine, Nature of Science, History of Science

Ed Hessler

STAT First Opinion Editor Pat Skerret (filling in for a colleague on maternity leave) chose an essay on colonoscopy, "the preventive measure everyone loves to hate." My reason for posting it is because is about evidence-based medicine - commonly used phrase today. It helped me understand that the idea is not always as clear as it sounds.

The essay is by Benjamin Lebwohlgastroenterologist and director of clinical research at the Celiac Disease Center at Columbia University. The title is "A liquid-only diet before a colonoscopy is unnecessary," First Opinion March 19, 2024.
The heading under which it was published is First Opinion. Keep that idea - opinion - in mind as you read it.

Lebwohl discusses the following:

--colorectal cancer is on the rise for people under 50 in the U.S. so it is important to convince people of the procedure

--the preparation procedure for a colonoscopy is rated by patients as the most difficult aspect. One of these is unavoidable - the purgative; the other, avoiding solid food for 24 hours before is, although diet during that period is important as Lebwohl explains.

--in 2013, a "large, randomized trial compared the results of two diet instructions the day before the colonoscopy. ... Clear liquids only, or a diet that permitted solid food." The foods allowed and the results are compared on "clean-outs" (colon free of food). Access to the study mentioned above is provided.

Lebwohl reviews similar studies in following years and his experience using the internet for searches on recommendations from respected institutions, patient advocacy groups and "obstacles in the diffusion of information." He also asked his colleagues.
Once again, this entry was written to illustrate the vexing issue of evidence-based medicine.

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