A Milkshake Prep For Colonoscopy? Dr. Rex Says It’s Coming

The dread of a colonoscopy has so much to do with guzzling down that gritty preparation. It can be gag-inducing. It can be downright unbearable.

But things are looking up for the future of the procedure down there. And that’s good news for millions. The colonoscopy is, arguably, the most commonly performed procedure in the United States.

We asked Douglas Rex, M.D., a world-renowned gastroenterologist with IU Health to tell us what’s to come for the colonoscopy.

Milkshakes? Yes, please

“Bowel preps are going to get easier and that will be a big thing in terms of tolerability,” says Dr. Rex. “We do lots of studies about bowel preparation and how to make it better. One of the ideas that’s generated some real interest recently is about prep put into shakes and food bars.” Yes, please.

You missed that one, doc

“Colonoscopy is an area being intensely studied to try and get it as perfect as possible. Some of the things we are going to see happening are artificial intelligence programs, deep learning programs, that will make the procedure better in real time,” he says. “First, they will assess if the doctor is really being careful. If you didn’t look behind a fold, it will tell you, ‘You need to look behind the fold.’ There will be programs that will highlight lesions. Maybe there is a flat lesion. It will tell you, ‘This is an area you need to look at more carefully.’ This will be important in reducing operator dependence.”

A near-perfect procedure

“I think we’re going to see colonoscopy get so good that people will be able to get scoped once or twice in a lifetime and, if they’re normal, that’s it,” Dr. Rex says. “We’ll be able to just say, ‘You’re never going to get colon cancer.’”

Bye-bye screening colonoscopy?

“At some point, there are going to be tests that are good enough to detect polyps and cancer that colonoscopy won’t be used as a screening test,” he says.

Not necessarily new, but we asked Dr. Rex: When should we get a colonoscopy?

• African Americans with no family history of colon cancer should get their first screening colonoscopy at age 45.
• All other ethnicities with no family history should start at age 50.
• If you have one first-degree relative who was diagnosed with colon cancer after age 60, then you should get your first screening colonoscopy at age 40.
• If you have one first-degree relative diagnosed with colon cancer under the age of 60 or multiple first-degree relatives diagnosed with colon cancer at any age, then you should get your first screening colonoscopy at age 40 -- or 10 years before the youngest affected relative’s age at diagnosis -- whichever is earliest.

-- By Dana Benbow, Senior Journalist at IU Health.

Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.