Mechanical bowel preparation in gynaecological surgery--are we doing more harm than good?

Matthys H. Botha
In: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2007 · vol. 97(11) , pp. 1040, 1042–3 · PMID:18254196 · W2139418504
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Abstract

Bowel preparation is still regarded as standard practice before extensive gynaecological surgery.It is requested routinely if there is a potential malignancy or if multiple adhesions are expected.This widely used practice is coming under increasing scrutiny, and our dogma needs to change.Colonic irrigation for the treatment of constipation has been known since ancient times.The first recorded reference to colon cleansing is in the Ebers Papyrus, an Egyptian medical document, which has been carbon dated between 1500 and 1700 BC. 'Colonic hydrotherapy' is the modern equivalent and is practised widely in alternative medicine circles.Many websites advertise the services of colon hydrotherapists, stating, for example, 'Hydrotherapy is the gentle-ist [sic] and most effective treatment for constipation problems.Normally healthy people will find it valuable to take colon hydrotherapy every couple of months to experience how well one feels.'Such claims are widespread, and scientists may instinctively consider them nons(ci)ense as they are not based on facts.The difference between such claims and what we evidence-based practitioners call science is that our treatment is usually based on sound medical evidence.However, in the case of bowel preparation the evidence is very tenuous.

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