Colonoscopies carry higher infection risks than previously believed

colonoscopy-300x214More than 15 million Americans each year undergo an invasive medical test, roughly once a decade and starting at age 50. If some medical experts had their way, more patients would get this cancer checkup, beginning at an even younger age. But as Emily Bazar, a senior editor and consumer columnist (Ask Emily) for the independent, nonprofit Kaiser Health News service, points out, physicians may want to heal themselves and their hygiene practices before pushing even more patients to get colonoscopies and endoscopies (procedures to examine the upper gastrointestinal tract).

That’s because a growing body of research shows that the switch by doctors, hospitals, and specialty centers to reusable scopes to peer into various parts of the body have resulted in rising infection rates among colonoscopy and endoscopy patients, among others.

Inspections show that the reused scopes don’t get cleaned properly and all the time. The more complex the medical device, the greater the risk, as clinicians and patients learned when complex and dirty duodenoscopes were tied to the deaths of 35 patients since 2013 and the sickening of dozens of others, leading to congressional investigations, lawsuits, and product recalls.

Medical researchers since have scrutinized scopes’ use and cleanliness, finding them increasingly popular and widespread in use, even as they rack up checkered records for their sanitation and cleanliness. Bazar reported that a recent Johns Hopkins University study examined infection rates for a week for patients undergoing colonoscopies and endoscopies at free-standing specialty centers. Those facilities have burgeoned as convenient way to reduce costs for targeted medical services, including surgeries and other procedures, because they don’t carry high hospital overhead. But infection rates for the two scope screenings at such centers were much higher than previously thought: They once were believed to be about 1 in a million but experts in Baltimore calculated them, instead, at 1 in 1,000.

The Baltimore experts added:

Patients who’d been hospitalized before undergoing one of the procedures were at even greater risk of infection. Almost 45 in 1,000 patients who’d been hospitalized within 30 days prior to a screening colonoscopy visited a hospital with an infection within a month. Within those same parameters, the rate of infection-related hospitalization for EGDs was more than 59 patients per 1,000.

In my practice, I see the harms that patients suffer while seeking medical services, including the increasing havoc wreaked on them by defective and dangerous products, notably medical devices. “The Bleeding Edge,” a new documentary available on Netflix, shows how the medical device industry delivers not only big promises but also big pains for patients who suffer major harms and financial set-backs from poorly designed and tested products.

Jeanne Lenzer, a seasoned medical investigative reporter, has pointed out in her recent book that 32 million Americans — about one in 10 of us — have at least one medical device implanted in our bodies. These include artificial joints, cardiac stents, surgical mesh, pacemakers, defibrillators, nerve stimulators, replacement lenses in eyes, heart valves and birth control devices. We’re also poked, prodded, and exposed to an array of medical devices used in tests and procedures, including robotic and laparoscopic or key-hole surgeries. These devices have caused major damage to patients, including spreading cancers in their bodies or leaving ghastly flaws that have allowed women’s bowels to fall through their vaginas.

Skepticism abounded already when the American Cancer Society shifted its recommendations to urge more Americans to undergo colorectal screenings, including potentially colonoscopies, at an earlier age. Medical experts already have warned that this procedure is uncomfortable, invasive, and may have underreported risks and complications, as well as it may be over-ordered by doctors as part of defensive medicine.

As Bazar’s column emphasizes, good doctors should be plenty patient and willing to not only explain to you why you might need a colonoscopy (as shown in U.S. Navy photo, above) — which may be covered by your insurance but still costs anywhere from roughly $1,500 to $5,000 — but also your risks and their precautions, including equipment hygiene and anesthetic safety, when you undergo this procedure. If your practitioner can’t find time to do so, find another specialist — and stat.

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