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March 24, 2008

Purging the Colon While Preserving the Kidneys

Arch Intern Med. 2008;168(6):565-567. doi:10.1001/archinte.168.6.565

Current screening techniques based on total colonic mucosal evaluation such as colonoscopy are powerful enough to actually prevent 75% to 90% of all colorectal cancer (CRC) cases through the identification and removal of the precursor lesions, adenomatous polyps.1 Unfortunately, the poor compliance with these tests contributes significantly to the reason that CRC still ranks as the second leading cause of cancer deaths among Americans.2 While there are many reasons for this patient reluctance (eg, cost, discomfort, and embarrassment), one important barrier to invasive CRC screening is the unpleasant nature of colonic purge. Indeed, a recent prospective study identified laxative preparation as the major disincentive for patients to undergo CRC screening with either colonoscopy or computed tomographic colography (virtual colonoscopy).3 Thus, optimizing colonic preparation may have significant public health ramifications.

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