What to Take Before a Colonoscopy

What to Take Before a Colonoscopy
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By preventing colon spasms, peppermint oil can both reduce the pain and discomfort of colonoscopies for the patient, as well as make insertion and withdrawal of scope easier for the doctor.

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Peppermint was not officially described—by a white guy—until 1696, but we’ve probably been using it for at least a few thousand years. After-dinner mints are used to reduce the gastrocolic reflex, the urge to defecate following a meal. The stretching of nerves in the stomach triggers spasms in the colon, which makes sense—our body’s making way for more food coming down the pipe. What peppermint does is relax the muscles of the colon.

If you take circular strips of human colons removed during surgery and just lay them on a table, they spontaneously contract on their own about three times a minute. Isn’t that kind of creepy? But then if you drop more and more menthol from peppermint on them, the contractions still happen, but they’re not as strong. Well, if peppermint can relax the colon and reduce spasms, might it be useful during a colonoscopy, as first suggested over 30 years ago. See, colon spasm can hinder the progress of the scope and cause the patient discomfort. So, they tried spraying some peppermint oil out the tip, and in every case, the spasm was relieved within 30 seconds. 30 seconds is a long time, though, when you have this snaking inside of you; so, the next innovation would be to just use a hand pump to flood the whole colon with a peppermint oil solution before the colonoscopy. Simple, safe, and convenient alternative to injecting an anti-spasm drug, which can have an array of side effects, whereas instilling some peppermint solution, dyed blue in the picture here, and within 20 seconds, the spasming colon opens right up.

Similar results were attained with upper endoscopy, working better, quicker, safer than the drug, and also when mixed into barium enemas. But wouldn’t it be easier to just swallow some peppermint oil instead of squirting it up the rectum? Premedication with peppermint oil in colonoscopy. Just popping a few peppermint oil capsules four hours before the procedure sped up the entire process, and increased both doctor and patient satisfaction, because reducing colon spasm reduces pain and discomfort, and makes the scope easier to insert and withdraw.

Pain and discomfort are not the only barriers to signing people up for colonoscopies, though. Even if peppermint oil makes it go seamlessly, there’s still the dreaded bowel prep, where you have to drink quarts of a powerful liquid laxative before the procedure to completely clean you out. And, aside from the pain, a fear of complications and feelings of embarrassment and vulnerability.

Serious complications occur in about 1 in every 350 colonoscopies: everything from perforations and bleeding to death. Perforations occur when the tip of the scope punches through wall of the colon, or because they inflated the colon too much—they have to pump in air so they can look around, or when they’re trying to cauterize some bleeding caused by like a biopsy, which, in extremely rare instances, can ignite some residual gas and cause the colon to explode.

Death from colonoscopy is rare, occurring only in about 1 in every thousand procedures, but with about 15 million colonoscopies performed annually in the United States, colonoscopies kill about 15,000 Americans every year, raising the question: do the benefits outweigh the risks? I’ll cover that next.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to darwin Bell via Flickr.

Peppermint was not officially described—by a white guy—until 1696, but we’ve probably been using it for at least a few thousand years. After-dinner mints are used to reduce the gastrocolic reflex, the urge to defecate following a meal. The stretching of nerves in the stomach triggers spasms in the colon, which makes sense—our body’s making way for more food coming down the pipe. What peppermint does is relax the muscles of the colon.

If you take circular strips of human colons removed during surgery and just lay them on a table, they spontaneously contract on their own about three times a minute. Isn’t that kind of creepy? But then if you drop more and more menthol from peppermint on them, the contractions still happen, but they’re not as strong. Well, if peppermint can relax the colon and reduce spasms, might it be useful during a colonoscopy, as first suggested over 30 years ago. See, colon spasm can hinder the progress of the scope and cause the patient discomfort. So, they tried spraying some peppermint oil out the tip, and in every case, the spasm was relieved within 30 seconds. 30 seconds is a long time, though, when you have this snaking inside of you; so, the next innovation would be to just use a hand pump to flood the whole colon with a peppermint oil solution before the colonoscopy. Simple, safe, and convenient alternative to injecting an anti-spasm drug, which can have an array of side effects, whereas instilling some peppermint solution, dyed blue in the picture here, and within 20 seconds, the spasming colon opens right up.

Similar results were attained with upper endoscopy, working better, quicker, safer than the drug, and also when mixed into barium enemas. But wouldn’t it be easier to just swallow some peppermint oil instead of squirting it up the rectum? Premedication with peppermint oil in colonoscopy. Just popping a few peppermint oil capsules four hours before the procedure sped up the entire process, and increased both doctor and patient satisfaction, because reducing colon spasm reduces pain and discomfort, and makes the scope easier to insert and withdraw.

Pain and discomfort are not the only barriers to signing people up for colonoscopies, though. Even if peppermint oil makes it go seamlessly, there’s still the dreaded bowel prep, where you have to drink quarts of a powerful liquid laxative before the procedure to completely clean you out. And, aside from the pain, a fear of complications and feelings of embarrassment and vulnerability.

Serious complications occur in about 1 in every 350 colonoscopies: everything from perforations and bleeding to death. Perforations occur when the tip of the scope punches through wall of the colon, or because they inflated the colon too much—they have to pump in air so they can look around, or when they’re trying to cauterize some bleeding caused by like a biopsy, which, in extremely rare instances, can ignite some residual gas and cause the colon to explode.

Death from colonoscopy is rare, occurring only in about 1 in every thousand procedures, but with about 15 million colonoscopies performed annually in the United States, colonoscopies kill about 15,000 Americans every year, raising the question: do the benefits outweigh the risks? I’ll cover that next.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to darwin Bell via Flickr.

Doctor's Note

I was shocked to find out how risky colonoscopies are, but dying from colon cancer is no walk in the park either. There’s got to be a better way, and I cover that topic in my video, Should We All Get Colonoscopies Starting at Age 50?

For more on iatrogenic (doctor-induced) risks of various medical procedures, see:

You can also learn more about the benefits of all kinds of mint in:

And what about preventing colon cancer in the first place? See:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

61 responses to “What to Take Before a Colonoscopy

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  1. One in 1000 dead from a colonoscopy? That’s some serious risk. Eat more plants. Thanks for digging this information up once again. Death by the Blacksnake.




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    1. I agree that it seems like a very big risk to me. I would not consider that rare.

      Then again, I think I rarely agree with what a specialist considers rare. I was recently told that complications from root canals is rare. When I asked for details, I was told that 2% of root canals have complications. Two out of every hundred?!? That’s *not* rare!




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      1. It’s a chilling reality – one often overlooked in annual mortality statistics: Preventable medical errors persist as the No. 3 killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year. At a Senate hearing Thursday, patient safety officials put their best ideas forward on how to solve the crisis, with IT often at the center of discussions.




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        1. According to ‘The Annals Of Internal Medicine,’ the rate of serious complications from colonoscopy screening is “10 times higher than for any other commonly used cancer-screening test.” This number doesn’t include deferred complications, such as internal bleeding, severe anemia, heart attack, stroke, pulmonary embolism, pneumonia, kidney failure, intestinal obstruction, and others.

          These complications explain why, according to the Telemark Polyp Study I, colonoscopy screening increases relative mortality by 57%. Thus, if you are seriously considering to undergo screening, your odds of being killed or injured by the side effects of colonoscopy may actually exceed your odds of getting colorectal cancer in the first place [1].

          Adding insult to injury, all that prep, fear, risk, expense, embarrassment, and stress are for naught anyway — screening colonoscopy offers near zero protection from colon cancer, as I explain in my Death By Colonoscopy report.

          https://www.gutsense.org/crc/crc_side_effects.html




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          1. I have read recommendations by alternative doctors for sigmoidoscopy instead of colonoscopy. This is much less invasive and less dangerous, going not nearly as deeply into the colon. This leads me to wonder if most dangerous polyps and tumors are near the end of the colon near the rectum. If this is so, it makes even more sense to have the less invasive and dangerous procedure if there seems to be a need, such as blood found in the feces or toilet.




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      2. Read up on WHAT the “complications” are, who is likely to get them, and, BALANCE those against living with the pain and risk of meningitis! Use your head!!!




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        1. I did look into the details. Also meningitis is not even a little issue in my case. Not sure why you assume it is.

          Mark – A little more politeness please. From the rules for posting on this site:
          “The intention of the comment section under each video and blog post is to allow all members to share their stories, questions, and feedback with others in a welcoming, engaging, and respectful environment.”




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          1. It wasn’t directed at you specifically, I apologize for that. However, I find this all so anti-orthodox, inflammatory 9uh, not taking your Turmeric?) that I have to be the voice of (some ) reason. You mix “science” with woo-woo; but, I’m sure you don’t want to hear that.




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            1. Mark: re: “You mix “science” with woo-woo…”
              Again, not sure if you are using a generic “you” to mean this site or “you” to mean me personally. Either way: rather than make general disparagements, I recommend submitting more specific posts on a particular topic so that people can understand what your “voice of reason” is.

              Or put another way, I have no idea what you are talking about as this site seems pretty science-based to me. So, if you have a specific issue you could comment on, giving your own examples of how the science supports your point of view (all without trying to put down others), that would help facilitate some real communication and make for some interesting conversation.




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    2. I’ve noticed a tendency of vegetarians and vegans and those who say they
      eat a “clean” diet to believe they have transcended the possibility

      of contracting cancers. Simply. Not. True. I have as much distrust of
      Western medicine as anyone (perhaps more since I’ve had some iatrogenic
      near-misses)
      but I AM grateful for the diagnostic tools available to me and I take
      full advantage of them. I worked with women with cancer for
      many
      years in a community that abounds with organic foods and farmers’
      markets and has a high percentage of vegans/vegetarians (Santa Cruz,
      CA).
      I knew many young women with WFPB diets who were struggling with their
      various cancers. Some of these women had avoided annual exams and diagnostic
      screenings, believing there was no way they could get cancer. They
      sometimes ended up getting diagnosed with cancers in more advancedand/or untreatable stages.

      Please carefully weigh the risks of a colonoscopy against the risks of a delayed diagnosis of colon cancer.




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      1. It’s not about transcending risk it’s about minimizing risk!
        And the USPSTF recommends (as well as I) to perform a stool hemoccult card first (taking a couple of stool samples to have tested for blood because cancers of the colon bleed–no ‘ramming’ the Big black snake around your colon) which is very sensitive for picking up anything that may be bleeding in your colon whether that be hemorrhoids or cancer. If that comes up positive you could have an anoscopy performed to look for hemorrhoids, and if that is negative then you can have a sigmoidoscopy since most cancers are in the descending colon. If that is negative they could ram that thing all the way over to your cecum to look for the blood source. It’s the ‘ramming’ thing that causes the colon perforations.
        What I have just explained here is how to minimize risk from a testing standpoint. Once again it’s about minimizing risk but unfortunately not eliminating it.
        I hope this helps.




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        1. This IS very helpful. I’m writing down your recommendations. I hope other folks will, too, and will be proactive with the stool hemoccult card, etc. Thanks HD, MD.




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        2. Hi Dr. As ugly as it sounds, you (I think) are describing it pretty accurately. This whole rectal diagnostic system is completely invasive (as well as makes my stomach queasy thinking about this…I am hopeful it’s not as bad when done gently and properly). You’re correct again, from my limited knowledge of medicine, that the PCP should recommend a hemoccult card first. I am pretty sure that a colonoscopy should be the second to last thing to do in a person’s body for diagnostics purposes (right before either surgery or another treatment, but should be reserved later in the monitoring cycle) just based on the risks of complications stated (1 in a thousand colonoscopies causing on the table serious complications or death). Thank you again for your time and consideration of our health questions.




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  2. apart from the colonoscopy who may benefit from a peppermint due to the reduce gastrocolic reflex? and for who is not recommend ?
    for exsample if somebody have colonic spams but have a slow digestion ( going less than one time a day to poo) is good or bad to this person to take peppermint ? or actually can make the digestion even slower?




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  3. Why would a person eating a WFPB diet, exercising regularly, not smoking, not drinking alcohol, not doing drugs need colonoscopy in the first place?




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    1. Well, for example, I am all of those things, but my dad got colon cancer and my grandfather died from it. It is one of the most common cancers.
      John S




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      1. I agree with John. See my reply above. I eat plant-based, but with my family history, I reluctantly submit to colonoscopies. After watching my younger sister die, I decided it was worth the risk.




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      2. John, did your grandfather eat WFPB and do all the other things mentioned by George. If not keep in mind that genes can be turned on and off. The diet and lifestyle you are on should turn the cancer genes off.




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        1. No, my grandfather did not. My dad exercises and eats some vegetables, but he still eats lots of cheap meat and meat fat, plus processed foods.

          You make a good point, but I didn’t realize that I needed to eat WFPB eating until I was 45-50 years old, so I’m starting to turn it around, but many cancers take decades to develop, so my late turnaround my be too late for prevention.




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      1. I’ve noticed a tendency of vegetarians and vegans and those who say they eat a “clean” diet to believe they have transcended the possibility of contracting cancers. Simply. Not. True. I have as much distrust of Western medicine as anyone (perhaps more since I’ve had some iatrogenic near-misses) but I AM grateful for the diagnostic tools available to me and I take full advantage of them. I worked with women with cancer for many years in a community that abounds with organic foods and farmers’ markets and has a high percentage of vegans/vegetarians (Santa Cruz, CA). I knew many young women with WFPB diets who were struggling with their various cancers. Some of these women had avoided annual exams and diagnostic screenings, believing there was no way they could get cancer. They sometimes ended up getting diagnosed with cancers in more advanced and/or untreatable stages.

        Please carefully weigh the risks of a colonoscopy against the risks of a delayed diagnosis of colon cancer.




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    2. Hello John & Will: In that case, whatever happened to that camera capsule that was touted as an agreeable replacement of the current humiliating – and dangerous, according to this video – procedure?




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    3. In the case of my partner, he had surgery on his colon at 19 and developed ulcerative colitis prior to starting a WFPB diet at 28, and bowel diseases are common in his family. He has no severe symptoms now, but is rechecked every few years. Perhaps it is unnecessary… perhaps not worth the risk of finding out it is necessary too late…?




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  4. Exploding colons caused by cauterization induced gas ignition? One death per 1,000 procedures leading to 15,000 deaths per year from colonoscopies in the US? This is considered rare?
    Yikes! Heck, the yearly odds of being murdered in Honduras is 1 in 1100. Who would have thought that a one year stay in a poverty stricken banana republic would be safer.




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    1. Joe: you cracked me up. Didn’t somebody say that laughter is the best medicine? If I keep laughing like this, I don’t have to worry about getting cancer, or anything.




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  5. My sister was diagnosed with stage 4 colon cancer at age 50 following her first colonoscopy. I believe in them. I had a colonoscopy a year later. They found a pre-cancerous serrated adenoma — one of the BAD ones. Unfortunately, in removing it, they also perforated my colon, requiring an emergency colon resection 36 hours later. A lot of pain. Very dangerous. Lost seven inches of colon, a valve, and my appendix (which I really don’t miss). Would I have another colonoscopy? Yes, unless they invent something better — I’ll have one every other year, given my history.




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    1. Peggy: The appendix apparently is not the useless thing biologists thought it to be. It plays an important role in controlling the immunity and a reservoir of probiotic bacteria. Anyway, glad you recovered.




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    1. Steer clear of hospitals, you’re more likely to
      die from a hospital acquired infection than die of colon cancer. Besides if you’re vegan your odds of colon
      cancer is a fraction of those following the SAD.




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  6. Dr McDougall covers this topic. He says there’s much less risk submitting to the sigmoidoscopy ages 55 to 60.

    I’m 60 and didn’t want to submit to either one, so my Dr sent me a lab testing kit so I could scrape some of my poo (test for blood) and send it back in the mail.

    That was easy peasy….lol I haven’t heard back about the test in about 2 months now, I hope it was ok.

    https://www.drmcdougall.com/misc/2014nl/aug/early.htm




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  7. I recently declined a colonoscopy, which would have been my second, in favor of Cologuard, “an easy to use, noninvasive colon cancer screening test based on the latest advances in stool DNA science. It is for adults 50 years or older who are at average risk for colon cancer, and it is available by prescription only.”

    It’s (only) a little less accurate than colonoscopy, without requiring any prep, risk, or having to have someone drive you home.

    http://www.cologuardtest.com/




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  8. I can’t find data about mortality rates for colonoscopy of 1/1,000. Instead, I find 1/10,000 per the following study referenced by Dr. Greger.

    Forensic Sci Med Pathol. 2012 Mar;8(1):4-12. doi: 10.1007/s12024-011-9257-2. Epub 2011 Jun 11.

    Upper and lower gastrointestinal endoscopy mortality: the medical examiner’s perspective.

    deRoux SJ1, Sgarlato A.

    Author information

    Abstract

    Fiberoptic endoscopy is utilized to diagnose and treat a wide variety of gastrointestinal tract diseases and is currently one of the most commonly performed invasive medical procedures. Though generally considered to be safe, the procedure may be associated with serious complications including death. Herein, we correlate the clinical history with the autopsy findings in gastrointestinal endoscopy (GIE) related fatalities that were reported to the New York City Medical Examiner Office over a 5 year period. The complication rate is higher in therapeutic procedures when compared to diagnostic procedures. Though fatalities following iatrogenic complications are four times more common, emphasis is placed on patients who died following a cardiorespiratory event during or immediately following the procedure. Of 41 upper and 36 lower GIE related fatalities, 10 and 9 respectively, fit this category. The comorbidities frequently associated with fatal cardiorespiratory events were: hypertension and obesity with associated cardiac hypertrophy, diabetes mellitus and coronary artery atherosclerosis. For colonoscopies, the approximate incidence of perforation was 0.00625% and the procedure-related fatality rate was 0.014%. The literature on anesthesia for GIE is also discussed.




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  9. I am having a conversation with David Zeevi a graduate student at the Weizmann Institute in Tel Aviv. He and his collaborators are looking for a dietary cure for our common diseases by doing research on the behavior of gut flora when certain foods are consumed. I told him that a WFPB diet already helps people with diabetes.

    Here is his answer:

    In “a validated dietary treatment for diabetes” I was referring to peer-reviewed work, preferably one performing a randomized double blinded clinical trial. Finding one such study that supports such a treatment would indeed convince me of its existence.

    People have been claiming to cure myriad illnesses for thousands of years…

    — David

    David can be contacted at his school. I don’t want to keep arguing with him on reddit, but I do believe his work could do a lot of good if he knew a WFPB diet worked. He could then look at the behavior of gut flora in people consuming a WFPB diet.

    What do you guys think. Can you help me?




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    1. Sure. Send him a link to Dr. Barnard’s study
      http://www.ncbi.nlm.nih.gov/pubmed/19339401
      and a link to Dr. Barnard’s book on Amazon
      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_2?s=books&ie=UTF8&qid=1448379857&sr=1-2&refinements=p_27%3ANeal+Barnard

      Say, while you’re at it, ask Mr. Zeevi where the Israelis’s are at curing cancer with cannabis. (For those of you who may not know, it was an Israeli who discovered THC as well as the human endocannabinoid system. Some great documentaries on the youtubes about this. Check it out. And then vote for cannabis wherever and whenever you can.)

      Thanks, 2tsaybow.




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      1. Thank you, Lawrence!

        I appreciate you taking the time to answer me. I will ask David about cannabis and curing cancer. It certainly works as a pain reliever. I put a pile in my coconut oil and I use it on my feet after I’ve worked out. It is remarkably healing.




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        1. So jealous…

          Out of immense respect for Dr. Greger, I feel it would be borderline irresponsible of me not to relate his impassioned admonition against smoking anything, especially cannabis, and that consuming green tea stimulates our endocannabinoid system:
          http://nutritionfacts.org/video/cannabis-receptors-food/

          Researchers in many places around the world are finding that cannabis does, indeed, have myriad medical uses, not the least of which is attacking cancer through multiple mechanisms of action, many of which should be familiar to those of us who frequent NutritionFacts.
          https://www.youtube.com/watch?v=DttdDOqQMuY

          In a rational society that places public good above private profit, cannabis research would be going gangbusters. The problem with cannabis is not that it doesn’t work, but that it works too well, and its widespread utilization would jeopardize the prevailing model of raking in profits from human misery. Every thinking person knows this is true. But, I digress.




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    2. I don’t know how anyone could do a double blinded trial of a whole food diet. t might simply be a lack of imagination on my part but the idea seems patently impossible.
      However, there have been some (much weaker) experimental studies conducted which are suggestive of efficacy. As well as the Barnard study mentioned by Lawrence, there was also Fuhrman’s case series study. Barnard also conducted a meta analysis of vegetarian diets and glycaemic control but, as we know, vegetarian diets don’t automatically equate to WFPB diets.
      http://www.scirp.org/journal/PaperInformation.aspx?PaperID=21562

      http://www.thecdt.org/article/view/4977/5858




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      1. Thank you, Tom! You have no idea how hard is was for me to even challenge this person.
        Since he is a scientist, I felt had to go “pow” to get his attention by asking him if it was being educated in a cloistered environment, or if it was willful ignorance that kept him from being informed about a WFPB diet.
        I think he only answered me because I pissed him off.
        Maybe I should write him a nice letter and send him a copy of “How to Not Die.”




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        1. Thanks. He is, however, correct. There is no strong evidence that WFPB diets reverse T2D. That is not to say that they don’t – just that strong evidence is not there – after all, who’s going to fund such studies (unlike drugs, there’s no money in it)?

          However, the studies cited earlier (and others) are highly suggestive.
          http://spectrum.diabetesjournals.org/content/25/1/38.full
          It is also noteworthy that the US CDC recommends that diabetics eat more (in effect) whole plant foods eg
          http://www.cdc.gov/diabetes/managing/eatright.html

          In any case, it is almost universally accepted that greater consumption of whole plant foods eg whole grains, fruits and vegetables etc is associated with lower risk for T2D.
          http://www.hsph.harvard.edu/news/press-releases/healthy-diet-associated-with-lower-risk-of-type-2-diabetes-in-minority-women/
          http://www.cdc.gov/diabetes/prevention/pdf/curriculum_session4.pdf
          http://www.diabetes.org/are-you-at-risk/lower-your-risk/healthy-eating.html

          The idea that such diets can also reverse or effectively manage T2D is therefore quite reasonable.




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  10. McDougall recently said NO colonoscopy, too risky, better a sigmoidscopy or a couple of new tests for blood or some other markers, forgot the names. Doesn’t break my heart!




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  11. I had serious problems with hemorrhoids. I thought it was a Sexually Transmitted Disease, a terrible itchy rash on my bottom. I think it might have just been a Silicon deficiency. Drinking stinging nettle tea cured me immediately. I think a lot of people I knew that hemorrhoids from an early age. I guess some doctors call it anal puritis or hemorrhoids. I think many people not on a plant based diet will develop a Silicon deficiency soon or quickly. I think peppermint is a good but not perfect source of Silicon.




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    1. He (confusingly) wasn’t citing the study in the background, but probably the inset table which comes from another paper. There he is probably rounding up, but the (unadjusted for contributing causes) mortality rates from individual studies range from 1 to 8 per 10,000 if I recall correctly.




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  12. I do not need to see the next video. I will pass on colonoscopies. That is 1 dead in 1000 plus other problems that occur in 1 out of 350. Again. i pass !!!




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    1. But it looks like Greger’s view of the statistics may be biased toward the more dangerous end. The USPSTF, which he trusts enough to cite for its recommendation and review, states in its 2008 review from the sources cited here that the serious harms, including death, are about 2.5 per 1000 in the US, and these include more modest fallout such as “severe abdominal pain” and “diverticulitis”, which can be managed, often without permanent damage. Perforation seems most likely to be the mortality concern for people who are managing cardiovascular risk effectively, but total perforation rates (fatal and nonfatal) in their 2008 recommendation report are estimated at only 3.8 per 10,000. He doesn’t discuss this discrepancy or try to make adjustments for contributing causes of death.

      Perforation is still quite scary, but Greger’s estimates of the risk that really matters to many people here (which is basically some sort of weighted sum of mortality and long-lasting morbidity) may be off by as much as a factor of 4 or so, and this should impact decision making. It’s worth noting that the basis for the USPSTF’s recommendation of 3 possible screening strategies assumes that colonoscopy follows a positive test and that if adenomous polyps are detected, colonoscopy continues once every 3 to 5 years thereafter.

      Still, their microsimulation analysis does indicate that contemporary high-sensitivity occult blood tests are specific enough to make the non-endoscopic strategy (out of the 3 simulated) the most effective in reducing the total number of colonoscopies required, so it appears that fecal testing may be the most appropriate if your concern about cancer mortality is relatively low and if you are sure that you can get an appropriate annual regimen of high-sensitivity testing. Combining the best of two plans, for example flexible sigmoidoscopy or colonoscopy at 50 followed by annual fecal testing (with appropriate adjustment for proportionally higher false positive results), may be even more appropriate for people transitioning to this lifestyle from a past that was less angelic. This stuff should be discussed with someone knowledgeable, who can assess the information in the context of your own personal history and has a general plan for following up your screening results.

      I myself am hopeful that non-invasive screening technology will mature greatly in the next few decades, so present estimates of optimal screening strategy may become simply immaterial as time unfolds. Many people should just wait and see what happens in the future, rather than making a firm decision right now and closing their minds to all further information.




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  13. I wanted to know about the use of laxatives(eg. Castor oil) before fasting in these 2 cases:

    1. In the case of water fasting, I guess it is necessary to take a laxative the day before a fast so that prior to entering the fast your colon is clear. This is because if we enter without clearing the colon then because we aren’t eating any food so there won’t be any fiber intake, and if there is no fiber intake it becomes harder for the body to excrete it.

       Of course keeping these toxins in the body for too long will be harmful so the body forcefully excretes them in a semi-solid and liquid form similar to diarrhea( plus I guess this could happen anytime so one might end up shitting themselves in public. Eww..)

    2. In the case of fruit fasting here I guess a laxative won’t be needed because there is a fiber supply from fruits. So this will help in expelling the toxins. Therefore, it’s not necessary for a person to take a laxative I feel.

       Please let me what should be done in these cases. In case you do not know can you please give the email id of someone who you know can help. I shall wait eagerly in anticipation of your prompt response.




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