A New Choice For Colonoscopy Preparation
DANBURY, CT – January 24, 2008 – People sometimes avoid a colon cancer screening because
they fear the inconvenience of the cleansing preparation more than the colonoscopy itself.
Danbury Hospital is the first hospital in Connecticut and around the nation to offer an
alternative method to cleanse the bowel to prepare for a colonoscopy -- one that is more
convenient, quicker, and eliminates having to drink a gallon of liquid laxatives the night
before.
“Patients now have a choice,” said Joseph Fiorito, M.D., chief of the Section of
Gastroenterology, a nationally recognized program at Danbury Hospital, the regional medical
center and university teaching hospital.
The innovative new method is called colon hydrotherapy, a procedure that infuses warm,
filtered, chemical-free water into the colon to cleanse it prior to colonoscopy, a life-saving
screening that detects pre-cancerous polyps.
The infusion is done by a trained technician in a private room at the hospital, in a soothing
atmosphere with little discomfort to the patients. Patients lie on a stretcher on their backs and
sides for the 45-minute procedure that flushes water in and out of the colon prior to
colonoscopy.
With colon hydrotherapy, patients can avoid the inconvenience and often messy preparation of
drinking laxatives prior to the procedure. “Some people find the palatability of the liquid
unacceptable,” said Dr. Fiorito. “Many people can’t tolerate drinking the gallon of liquid
laxatives required the night before a colonoscopy to cleanse their colon.”
“Colon hydrotherapy is also much more convenient,” he added. “People don’t have to worry
about having to miss work, not eat for 24 hours and stay up all night because of diarrhea.”
Colon cancer survivor Ethel Pancotti of Danbury is one of the people who colon hydrotherapy
has greatly helped. She is among those who couldn’t tolerate the laxative process and would
suffer loss of electrolytes, eventually passing out and ending up in the Emergency
Department.
“With hydrotherapy, there’s no pain or discomfort,” she said. “I was so relaxed that I fell
asleep listening to music during the cleansing procedure.”
This procedure is especially beneficial for the elderly, said Dr. Fiorito, who sometimes can’t
tolerate the volume of liquid that they need to drink, along with feeling side effects from the
laxatives. They’re also more prone to electrolyte abnormalities and kidney damage from the
laxative cleansing process.
Doctors recommend having a colonoscopy beginning at age 50, and sooner if patients have a
history of colon cancer in the family, or other risk factors. For more information, visit
www.danburyhospital.org, or see your doctor.
Danbury Hospital is a 371-bed regional medical center and university teaching hospital
associated with New York Medical College, the Yale University School of Medicine, the
Connecticut School of Medicine and Columbia University Medical Center. It provides centers of
excellence in cardiovascular services, cancer, weight-loss surgery, orthopedics, digestive
disorders and radiology, with specialized programs for sleep disorders and asthma
management. More than 95 percent of the medical staff are board certified in their specialties.
It is ranked in the top 5 percent of hospitals in the country for overall clinical performance by
HealthGrades®, an independent health-care rating organization, for 2005 through 2007. In
addition, Danbury Hospital is a recognized leader named among the nation’s 100 Top
Hospitals® by Solucient, a leading national source of health care business intelligence.
It is No. 1 in Connecticut for overall gastrointestinal (GI) services and only one of seven
hospitals in New England to be ranked among the top 5 percent for overall GI services.
MEDICAL STUDY
This study was accepted and delivered as an oral presentation at the American College of
Gastroenterology -ACG- Annual Meeting, October 2006. (Only 1% to 2% of all studies
submitted, from thousands of abstracts are selected for oral presentation. A
testament to how important the ACG feels this topic and research is.)
* Study showed Hydrotherapy was good or better than alternative preparations and patients
preferred Hydrotherapy.
* 150 patients evaluated to compare Hydrotherapy to the present standard pre-colonoscopy
preparation Methods of Golytely and Fleets Phosphasoda.
Who performed the Medical Study?
Blind Study - Dr. Joseph Fiorito
ACG 2006 : The American College of Gastroenterology
Annual Scientific Meeting
Abstract Number : 751814
Primary Author : Joseph Fiorito
Department / Institute : Gastroenterology, Danbury
Hospital
Address : 24 Hospital Ave
City / State / Zip/ Country : Danbury, CT, 06810,
United States
Phone : 203-707-7506
Fax : 203-796-7974
E-Mail : joseph.fiorito@danhosp.org
Awards : No Award Selected
Abstract Categories : 11 Endoscopy
Presentation Preference : Either oral or poster only
ACG Research Grant : No
Key Words : Colonoscopy, cathartics, colon preparation.
Title : HYDROTHERAPY COMPARED WITH PEG-ES LAVAGE AND AQUEOUS SODIUM
PHOSPHATE AS BOWEL PREPARATION FOR ELECTIVE COLONOSCOPY : A PROSPECTIVE,
RANDOMIZED, SINGLE BLINDED TRAIL.
Joseph J. Fiorito, MD, Joan A Culpepper-Morgan, MD, Scott G. Estabrook, MD, Patricia Scofield,
LPN, Victor Usatii, MD and Jodi Cuomo, RpH2. Gastroenterology, Danbury Hospital, Danbury,
CT United States.
Purpose : Hydrotherapy is a method of colon cleansing using constant warm water lavage
using a contained temperature and pressure controlled device administered by a trained
technician. The aim of this study was to compare the efficacy and patient acceptance of same
– day hydrotherapy (HYDRO) with polyethylene glycol-electrolyte lavage (PEF-ES) and
aqueous sodium phosphate (ASP) in patients undergoing elective colonoscopy.
Methods : Consecutive outpatients referred for elective colonoscopy were randomly assigned
to receive 4 L PEG-ES (n=55), two doses of aqueous sodium phosphate (n=52), or same day
hydrotherapy (n=53), as bowel preparation. The endoscopists were blinded to the method of
preparation. The overall quality of the colon cleansing was evaluated with respect to the
adequacy of visualization of the right, transverse, and left colon. Patients were asked to rate
the preparation with respect to ease, convenience, and comfort using structured, validated
questionnaire. Results were analyzed using the chi square test.
Results : Endoscopists rated the quality of colon cleansing as good for the right : 62% ASP,
49% PEG-ES, and 92% HYDRO (p<0.001). For the transverse colon : 80% Asp, 63% PEG-ES,
and 100% HYDRO (p<0.001). For the left colon: 84% ASP, 67% PEG-ES, and 98% HYDRO
(p<0.001). Patients rated the preparations as easy : 87% ASP, 56% PEG-ES, 96% HYDRO
(p<0.001). Patients rated convenience : 61% ASP, 79% PEG-ES, and 98% HYDRO (p<0.001).
Patients rated for comfort : 71% ASP, 36% PEG-ES, and 94% HYDRO (p<0.001). Patients
were asked if they wanted a different preparation for the next colonoscopy : 48% ASP, 60%
PEG-ES, and 4% HYDRO (p<0.001).
Conclusion : The quality of colon cleansing, overall tolerance, comfort, and convenience were
significantly better for HYDRO. In the study ASP was better than PEG-ES for the same
parameters. Hydrotherapy should be further investigates as a viable alternative to PES-Es and
ASP for bowel preparation prior to colonoscopy.
* Manufacturer’s note : the equipment used in the study was the Toxygen Model BSC-UV, a
“closed system” manufactured by Dotolo Research Corp. The Dotolo Colon Irrigation system
has been cleared by the FDA for the intended use as described in the st
What are the Key Points of the Medical Study?
The current business has, as a key foundation, the benefits of a recent medical study.
The study was conducted by Joseph J. Fiorito, MD, FACG, Assistant Clinical Professor of
Medicine, Albert Einstein College of Medicine, Chief – Division of Gastroenterology at Danbury
Hospital, Connecticut.
The Hydrotherapy Study concluded that using colon cleansing procedures (Hydrotherapy or
hydro)were both preferred by patients over chemical preparations and by the doctors who
found it less likely that patients were not adequately cleansed for exams and procedures.
The Hospital has become an avid customer of the Company including expanding its use of the
services and products, having now expanded it purchase from one machine to three machines,
operating them regularly to our knowledge. This leads us to believe that other hospitals will
potentially also start with one and expand and if correct, the figures as to financial
performance may be far in excess of our estimates. Here are some key points of the study:
* 150 patients evaluated to compare Hydrotherapy to the present standard pre-colonoscopy
preparation Methods of Golytely and Fleets Phosphasoda.
* Study showed Hydrotherapy was good or better than alternative preparations and patients
preferred Hydrotherapy. This study was accepted and delivered as an oral presentation at the
American College of Gastroenterology -ACG- Annual Meeting, October 2006.
(Only 1% to 2% of all studies submitted, from thousands of abstracts are selected
for oral presentation. A testament to how important the ACG feels this topic and
research is.)
The presentation generated a great deal of interest. HydroHealth is recognized as the
corporation behind the research. The study was submitted for publication to the American
Journal of Gastroenterology and is waiting final acceptance and publishing. Hydrotherapy
appears not only cost effective, but may also contribute to revenues for gastro healthcare
providers as follows:
1. Increased total numbers of screening procedures due to easier and more acceptable
preparation method.
2. Eliminate failed procedures due to “poor prep."
3. Allow increased afternoon procedures due to preparation method with improved results.
Hydrotherapy is now being expanded at Danbury Hospital. It is the most requested
preparation method when patients are given a choice. The hospital has performed more than
200 pre-colonoscopy preparations to with excellent results and follow up studies are planned.
Efforts to obtain Medicare and insurance reimbursement codes are planned as studies are
published. Nationally recognized university based endoscopy centers are considering adopting
Hydrotherapy pending publication of studies. As proven by the study, the Hydrotherapy
prep is as good as the most popular prep, Fleets phos soda. The difference proven is
the patient compliance with the prep.
Another use for the Hydrotherapy is that it can be used if a patient undergoes a colonoscopy
and the endoscopist finds stool in the colon. Instead of canceling the procedure due to a poor
prep, the endoscopist can order the prep to cleanse the colon. While the patient is having
hydro the endoscopist can proceed with an endoscopy on another patient, keeping him/her on
schedule. Once the patient is done with hydro, they can proceed with the procedure as
planned. We are presently working on presenting the data to the insurance companies.
At present the hospital is charging a “room” fee for the procedure, which is paid out of pocket
at the time of service. $65.00. The hospital has used the hydro on patients not associated with
colons. Therapeutic cleansing for patients with chronic constipation.