Americans were wrong – bowel cleansing before colon surgeries brings no benefit for the patients

If you came to the doctor needing colon surgery, he will tell you to prepare. American doctors will tell you to cleanse your bowels – in other words, empty yourself out. Meanwhile in Europe doctors will not stress that too much. Now scientists from Finland conducted a study, which showed that bowel preparation, in a form of antibiotics administration and bowel cleansing, doesn’t really improve the outcomes of the procedure.

Patients are still commonly advised to cleanse their bowels before surgical procedures targeted at the colon. Image credit: Volganet.ru via Wikimedia (CC BY-SA 3.0)

And that is the goal, right? Doctors sometimes tell you to prepare in order for the procedure to be more successful. You want it to give the best chance of success you can and so you use antibiotics and, when time comes, laxatives. During the last several years, a number of extensive retrospective studies conducted in the United States were published, proving that bowel preparation and antibiotics significantly reduce surgical site infections. They were used to base the recommendation for the patients to prepare for the surgery. However, these studies have little impact in Europe.

Doctors say that bowel preparation is an extremely stressful and unpleasant procedure and it can only take place if it actually benefits the patient. Although there are studies showing that that is the case, doctors said that more randomized trials are necessary. Now a new study was carried out in four hospitals: the hospital of Helsinki, Oulu University Hospitals, Central Finland and Seinäjoki Central Hospitals. In total, 400 patients were involved, half of whom were randomised into a preparation group. People in preparation group were  given orally administered antibiotics combined with bowel cleansing. People in control group did not get such treatment before the surgery.

Scientists published results, which were not that surprising to experienced doctors – uncomfortable and stressful bowel cleansing didn’t seem to provide any benefit for the patients. MD Ville Sallinen, one of the authors of the study, said: “According to our findings, there were no differences in treatment outcomes between the groups. Bowel preparation did not reduce surgical site infections or the total number or severity of surgical complications. Neither was there any difference in the number of days spent at the hospital”.

Colectomies are already very stressful procedures. If you need one, chances are you have colon cancer or another serious condition. Advising for extensive preparations makes the entire experience even more stressful for the patient. If bowel cleansing brings no benefits, it should not be a part of regular guidelines. 

 

Source: University of Helsinki


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