# Making the most of a forced bowel cleanse **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 9, 2008, 11:57am UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147 "2008-10-09T11:57:42Z")\ **Posts on this page:** 9\ **Page:** 2
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [October 11, 2008, 6:02pm UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/21 "2008-10-11T18:02:48Z")
> [@What\_the](#): > > That’s kind of what I was thinking. > > Seems like much of the argument against cleansing is that it will do more harm than good. I thought that if the harm was already done, a few more days of just juice or whatever might increase the good. The only “good” here is that the Doc gets to look at a clean bowel. ---
**Author:** ![Szlater](https://avatars.discourse-cdn.com/v4/letter/s/90ced4/32.png) [@Szlater](https://boards.straightdope.com/u/Szlater)\ **Post date:** [October 11, 2008, 7:11pm UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/22 "2008-10-11T19:11:34Z")
> [@What\_the](#): > > Turned 50 and my health insurance deductible has been hit so **I volunteered for a colonoscopy.** I don’t understand the bolded bit. Why are you having a medical intervention “voluntarily”. As colonoscopies themselves carry risks wouldn’t a doctor performing one, where there was no clear pressing medical reason for the investigation, be putting a patient at risk for no good reason? ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [October 11, 2008, 8:19pm UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/23 "2008-10-11T20:19:43Z")
50 is the generally accepted age (AFAIK) to start getting colonoscopies, if the patient hasn’t had one before. It’s just a maintenance test when you reach the half century mark. ---
**Author:** ![Autolycus](https://avatars.discourse-cdn.com/v4/letter/a/22d042/32.png) [@Autolycus](https://boards.straightdope.com/u/Autolycus)\ **Post date:** [October 11, 2008, 8:26pm UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/24 "2008-10-11T20:26:46Z")
Is it wrong that I laughed upon the OP thread title combination? I imagine him or her sitting on the can and going ‘what the…?!’ ---
**Author:** ![Szlater](https://avatars.discourse-cdn.com/v4/letter/s/90ced4/32.png) [@Szlater](https://boards.straightdope.com/u/Szlater)\ **Post date:** [October 11, 2008, 8:59pm UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/25 "2008-10-11T20:59:52Z")
> [@Lynn\_Bodoni](#): > > 50 is the generally accepted age (AFAIK) to start getting colonoscopies, if the patient hasn’t had one before. It’s just a maintenance test when you reach the half century mark. Isn’t it usually preceded by a positive faecal occult blood test though? I’m having trouble finding any reviews (Cochrane or otherwise) on the effectiveness of colonoscopy without +ve FOBT. ---
**Author:** ![Harriet\_the\_Spry](https://avatars.discourse-cdn.com/v4/letter/h/e56c9b/32.png) [@Harriet\_the\_Spry](https://boards.straightdope.com/u/Harriet_the_Spry)\ **Post date:** [October 12, 2008, 12:24am UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/26 "2008-10-12T00:24:40Z")
At least here in the US, it’s generally recommended at 50 regardless. There is some debate about it, and IIRC \*\*Qadgop \*\*has posted some credible colonoscopy-skepticism here before. But colonoscopies are widely recommended for everyone every 5-10 years starting at 50 even with no other symptoms or tests. One cite supporting this is here: [Colonoscopy: Background, Indications, Contraindications](http://www.emedicine.com/med/TOPIC2966.HTM) ---
**Author:** ![Ignatz](https://avatars.discourse-cdn.com/v4/letter/i/3be4f8/32.png) [@Ignatz](https://boards.straightdope.com/u/Ignatz)\ **Post date:** [October 12, 2008, 12:40am UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/27 "2008-10-12T00:40:38Z")
> [@The\_Mermaid](#): > > The bowel clean out will do the job required for your procedure. Extending the cleanse or fast MAY make you think it’s beneficial because you can lose a drastic amount of weight during the process. Now the bad news, you will be very uncomfortable from the aching and cramping caused by fluid & electrolyte imbalances which could be fatal if prolonged. > > In short, do your bowel prep then follow your doctor’s instructions. I’m having one in about 10 days, also, and wondered the same thing. Not a total fast, just a mostly liquid diet, juices, Slim Fast, thin soups for a week, rather than just on the last prior day. ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [October 12, 2008, 1:15am UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/28 "2008-10-12T01:15:44Z")
> [@Szlater](#): > > Isn’t it usually preceded by a positive faecal occult blood test though? I’m having trouble finding any reviews (Cochrane or otherwise) on the effectiveness of colonoscopy without +ve FOBT. I believe that they’re recommended for just about everyone. I have issues with my digestive system, and I had to do some other tests, so I don’t know what, exactly, a normal recommendation would be, other than the colonoscopies are generally recommended for those of us who have reached the half century mark. I did NOT enjoy collecting fecal samples. On the other hand, I am glad to know that I am free of intestinal parasites. ---
**Author:** ![rekkah](https://avatars.discourse-cdn.com/v4/letter/r/ee59a6/32.png) [@rekkah](https://boards.straightdope.com/u/rekkah)\ **Post date:** [October 12, 2008, 11:48am UTC](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147/29 "2008-10-12T11:48:00Z")
> [@Szlater](#): > > Isn’t it usually preceded by a positive faecal occult blood test though? I’m having trouble finding any reviews (Cochrane or otherwise) on the effectiveness of colonoscopy without +ve FOBT. Here in the UK we do much less routine screening than is generally done in the US. This is partly down to money - for a screening program to be approved on the NHS it needs to be demonstrated that it will give enough benefits (in terms of lives saved/extra years of good quality life) for the cost invlved. It’s not just money though and all screening programs should be pretty rigorously evaluated against the WHO screening guidelines before they are implemented. Currently the UK Bowel Cancer Screening program is just getting going and not active in all areas (though it will be eventually). It’s recruiting people aged 60-69 and as you say, consists of a FOB test first followed by colonoscopy if that’s positive. People under 60 are not being recruited as the risk of bowel cancer is lower in that group so screening would be less cost effective. People aged 70 and above can ask to be screened, but they aren’t being routinely recruited. This is because although the risk of bowel cancer is actually higher in this age group, they are less likely to get substantial benefit (extra years of good quality life) as a result of screening. The FOB test is not perfect, it’s a lot less sensitive than colonoscopy. However, it’s much less invasive, doesn’t carry a risk to the patient (colonoscopy has something like a 1% risk of bowel perforation and a very small risk of death resulting from that IIRC) and is much much cheaper. Some patients do get routine colonoscopy, but usually only those who have a particularly high risk for bowel cancer (previous bowel cancer, a genetic susceptibility, imflammatory bowel disease etc). Obviously the health economics are the major reason for differences between the two systems but I have to wonder if anyone has ever looked into the benefit:harm ratios for 50 year olds with no known extra risk of bowel cancer routinely undergoing a fairly invasive (and not risk free) test. [Previous page](https://boards.straightdope.com/t/making-the-most-of-a-forced-bowel-cleanse/467147.md?page=1)