Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort

Kobe, Elizabeth A.; Sullivan, Brian; Qin, Xuejun; Redding, Thomas S.; Hauser, Elizabeth R.; Madison, Ashton; Miller, Cameron; Efird, Jimmy T.; Gellad, Ziad F.; Weiss, David G.; Sims, Kellie J.; Williams, Christina D.; Lieberman, David A.; Provenzale, Dawn

doi:10.1016/j.gie.2022.04.1343

“…Post-colonoscopy induced symptoms are often abdominal pain, bloating, diarrhea, or constipation ( 7 , 25 , 39 ). A recent publication reports bloating in 25% of the analyzed patients as well as abdominal pain and discomfort in 5%-11% of the analyzed cases, as the most common adverse effects after colonoscopy ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

“…The gold standard for CRC-prevention by removal of benign polyps and by early CRC-detection is colonoscopy in asymptomatic individuals ( 4 ). Most European countries and a multiplicity of countries worldwide developed preventive programs from age of 50 with ten years of screening intervals ( 5 – 7 ). Colonoscopy is a generally safe and well-tolerated method to visualize the distal terminal ileum and the entire colon ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy

Labenz

¹

,

Borkenstein²,

Heil³

et al. 2023

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Even after decades of research and pharmaceutical development, cancer is still one of the most common causes of death in the western population and the management of cancer will remain a major challenge of medical research. One of the most common types of cancer is colorectal cancer (CRC). Prevention by detection of early-stage precursors is the most reliable method to prevent CRC development. In dependence of age, familial predisposition, and other risk factors the preventative routine screening for CRC by colonoscopy should be performed at least twice in intervals of about ten years. Although colonoscopy is a life-saving clinical examination reducing both incidence and mortality of CRC significantly, it has still a bad reputation in the population as an uncomfortable procedure with unpleasant side effects lasting sometimes over days to weeks. These effects are most likely caused by the bowel preparation before colonoscopy, which is crucial for a successful colonoscopy with high quality. Beside pain, bleeding and other rare but severe complications of colonoscopy, cleaning of the intestinal mucosa alters the gut microbiome significantly and consistently. Abdominal pain, cramps, diarrhea, nausea, bloating, and constipation are common adverse events which can continue to affect patients for days or even weeks after the procedure. In this multicenter, placebo controlled, double blind clinical trial, we investigated the effect of an intervention with a multispecies probiotic formulation for 30 days on the adverse events due to bowel preparation. We show that the treatment of participants with the multispecies probiotic formulation decreases the number of days with constipation significantly, and reduced pain, bloating, diarrhea, and general discomfort. 16S based amplicon analyses reveal recovery of administered probiotic strains from stool samples and differences in alpha diversity dynamics with higher variability in the probiotic group compared to the placebo group. In conclusion, the probiotic ameliorates the side effects after colonoscopy and might be an important supplement to increase acceptance of this life-saving preventative examination. Further, we present here for the first time that probiotic intervention of only 30 days affects alpha diversity parameters in stool samples.

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“…Post-colonoscopy induced symptoms are often abdominal pain, bloating, diarrhea, or constipation ( (7,26,41). A recent publication reports bloating in 25% of the analyzed patients as well as abdominal pain and discomfort in 5%-11% of the analyzed cases, as the most common adverse effects after colonoscopy (41).…”

Section: Discussionmentioning

confidence: 99%

“…The gold standard for CRC-prevention by removal of benign polyps and by early CRC-detection is colonoscopy in asymptomatic individuals (4). Most European countries and a multiplicity of countries worldwide developed preventive programs from age of 50 with ten years of screening intervals (5)(6)(7). Colonoscopy is a generally safe and well-tolerated method to visualize the distal terminal ileum and the entire colon (8,9).…”

Section: Introductionmentioning

confidence: 99%

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy

Labenz

¹

,

Borkenstein

²

,

Heil

³

et al. 2022

Preprint

0

View full text Add to dashboard Cite

Even after decades of research and pharmaceutical development, cancer is still one of the most common causes of death in the western population and the management of cancer will remain a major challenge of medical research. One of the most common types of cancer is colorectal cancer (CRC). Prevention by detection of early-stage precursors is the most reliable method to prevent CRC development. In dependence of age, familial predisposition, and other risk factors the preventative routine screening for CRC by colonoscopy should be performed at least twice in intervals of about ten years. Although colonoscopy is a life-saving clinical examination reducing both incidence and mortality of CRC significantly, it has still a bad reputation in the population as an uncomfortable procedure with unpleasant side effects lasting sometimes over days to weeks. These effects are most likely caused by the bowel preparation before colonoscopy, which is crucial for a successful colonoscopy with high quality. Beside pain, bleeding and other rare but severe complications of colonoscopy, cleaning of the intestinal mucosa alters the gut microbiome significantly and consistently. Abdominal pain, cramps, diarrhea, nausea, bloating, and constipation are common adverse events which can continue to affect patients for days or even weeks after the procedure. In this multicenter, placebo controlled, double blind clinical trial, we investigated the effect of an intervention with a multispecies probiotic formulation for 30 days on the adverse events due to bowel preparation. We show that the treatment of participants with the multispecies probiotic formulation decreases the number of days with constipation significantly, and reduced pain, bloating, diarrhea, and general discomfort. 16S based amplicon analyses reveal recovery of administered probiotic strains from stool samples and differences in alpha diversity dynamics with higher variability in the probiotic group compared to the placebo group. In conclusion, the probiotic ameliorates the side effects after colonoscopy and might be an important supplement to increase acceptance of this life-saving preventative examination. Further, we present here for the first time that probiotic intervention of only 30 days affects alpha diversity parameters in stool samples.

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Colorectal Cancer Polygenic Risk Score Is Associated With Screening Colonoscopy Findings but Not Follow-Up Outcomes

Sullivan,

Qin,

Redding

et al. 2024

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Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort

Cited by 8 publications

References 46 publications

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy

Application of a multispecies probiotic reduces gastro-intestinal discomfort and induces microbial changes after colonoscopy

Colorectal Cancer Polygenic Risk Score Is Associated With Screening Colonoscopy Findings but Not Follow-Up Outcomes

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