From LEF's Daily News via Greensboro News & Record

Preparation H: Hydrotherapy

04-01-08

GREENSBORO -- This past fall, Pamela Gibson needed a colonoscopy. But she had a problem.

The traditional preparation for that procedure requires the patient to drink large quantities of harsh laxatives to clean out the colon. These laxatives come in the form of, or must be taken with, large quantities of liquid.

The colon must be emptied, though, or the doctor performing the procedure can't thoroughly examine the inside of it for cancer or precancerous growths.

A thorough exam is essential to detecting and removing them because colorectal cancer is the third most common type of cancer in men and women and the second-leading cause of cancer deaths.

It's also one cancer for which early detection means excellent odds of survival. About 60 percent of colorectal-cancer deaths could be prevented if everyone 50 and older received proper screening tests, the Centers for Disease Control and Prevention estimates.

But Gibson told her gastroenterologist , Dr. Jeffrey Medoff , that she has a medical condition that would make it difficult, if not impossible, to swallow a lot of liquid.

Medoff had read about a doctor in Connecticut who had been asked by a patient whether colonic hydrotherapy wouldn't work just as well as laxatives in cleaning out the colon. colonic hydrotherapy involves inserting a tube into a person's rectum and filling the colon with water to flush out the contents.

The doctor, Joseph Fiorito , and other researchers assembled three groups of patients. Two groups received one of the traditionally used laxatives; the third group received colonic hydrotherapy just before their colonoscopies.

In the study, reported in 2006 in the American Journal of Gastroenterology , the doctors reported that hydrotherapy worked better than the laxatives in clearing out the colon.

The patients rated hydrotherapy higher on ease, convenience and comfort. Patients who received hydrotherapy also were less likely than laxative users to say they would prefer a different approach next time.

Medoff met with Pam Crawford , owner of Greensboro's Sunrise Colon Hydrotherapy , to discuss trying hydrotherapy for Gibson as an alternative to the laxatives.

"I went over my technique with him and showed him around the office and explained how I did the procedure," Crawford said. "And he had me contact Dr. Fiorito's group ... to see exactly how they had done the procedure and what their results were."

Satisfied, Medoff offered the option of hydrotherapy to Gibson. Gibson, who had had one previous colonoscopy using traditional preparation, was willing. And she would be able to go straight from the hydrotherapy to her colonoscopy, thus getting preparation and procedure finished in a single day.

"I was really a little concerned about the privacy, about what it would feel like, who was doing it," she said.

She needn't have worried.

"It actually was very private," she said. "It was kind of comforting. There was no pain. (Crawford) had soft music playing. They put warm blankets on you. It was just her in there. Everything was really quiet. They put a warm heating pad over your eyes. It's almost like going to sleep."

Then, with Gibson and Medoff's permission, Crawford watched Gibson's colonoscopy at Medoff's office.

Afterward, all three were pleased -- even Medoff, who is skeptical of some of the health benefits sometimes claimed by hydrotherapy practitioners.

"Don't get me wrong -- I'm not a big fan of colonics" in general, Medoff said. "But in this case it worked."

Since then, Medoff has had about half a dozen patients undergo hydrotherapy and has more scheduled.

"I had one patient who has been scoped twice who passed out during prep both times (because of) dehydration," Medoff said. "He said, Jeff, we have got to find another way to do this.' "

Medoff points out two disadvantages to hydrotherapy. Unlike traditional preparation, it can't be performed at home. And health insurance won't cover it. (Crawford charges $80 for a single session.)

Ideally, Medoff said, hydrotherapy and colonoscopy would be performed at the same site. But because of the finances involved, he doesn't see that happening anytime soon.

Medoff has relayed patient feedback on the procedure to Crawford.

"He wants to let me know how the patients have done, which is really thoughtful," she said. "He lets me know how the technique is working, because (patients) talk to him when I'm not around and can give him honest feedback."

Gibson is sold.

"It was a very pleasant experience," she said, "as pleasant as it could be."

Contact Lex Alexander at 373-7088 or lex.alexander@news- record.com