Virtual Colonoscopy: Expert Interview

Is Virtual Colonoscopy a Pain-Free Cancer Screening? The Scan Experts Answer Your Questions

Has your doctor recommended that you get a virtual colonoscopy (VC)? Many primary care physicians are now recommending virtual colonoscopy as a component of a routine physical exam, particularly for patients who are 50 or older. Here, the ScanDirectory experts answer your questions.

Q: Why would I need to get a virtual colonoscopy?

If you are over the age of 50 or have a prior history of colorectal polyps, you may be a candidate for virtual colonoscopy. Many people are at risk for colorectal polyps or have rectal bleeding or some other colonic problem that presently causes no symptoms. Virtual colonoscopy is a newer and faster screening test to assess the colon. This screening helps detect polyps, which can be removed early, before they become cancerous—so a virtual colonoscopy is a diagnostic that aids in prevention of colorectal cancer.

The best screening test to evaluate the colon is a regular colonoscopy, but there are few specialists who perform regular colonoscopy and millions of patients who should be screened.

Q: What type of preparation is required for virtual colonoscopy?

The preparation is designed to cleanse the colon of all fecal material. Thus, the day before the procedure, all individuals are required to stay on a liquid diet and take various laxatives and suppositories. Any remnant fecal material can interfere with adequate visualization of the inner colon. Frequently, patients are asked to take some oral barium tablets which will tag the fecal material and allow for discrimination from polyps.

Q: Where is virtual colonoscopy done and what can I expect?

A virtual colonoscopy is a screening with CT scan that is usually done in the radiology department at a hospital. The screening takes about 10-15 minutes and requires no sedation. During the screening, you will be asked to lie on a table. A small plastic tube will be placed in the rectum, and some air will be pumped through the tube, which distends the colon and rectum. The distended colon and rectum allow for better assessment of the colon by the CT scan. The table then moves into the scanner tunnel so that cross-sectional images can be obtained. You will then be asked to lie on your stomach and the process repeated. The scanned images are then placed on a computer which generates 3-dimensional images of the colon. After the VC, you may feel gassy and have a sensation of needing to go to the bathroom. All patients go home soon after the procedure and can resume normal activities the same day.

Q: Is a virtual colonoscopy painful?

Most patients describe this screening as an “unpleasant sensation” rather than a painful one. Having a small tube placed in the rectum is not comfortable and, when air is pumped into the colon, most patients complain of some abdominal cramping. These cramps subside after the screening.

Q: What happens if my virtual colonoscopy is abnormal?

If any abnormalities are discovered on virtual colonoscopy, it is very highly recommended that a conventional colonoscopy be done as the next step. You will be referred to a gastroenterologist who specializes in conventional colonoscopy, so you can undergo that diagnostic procedure as soon as it can be scheduled.

Q: What are the advantages of a virtual colonoscopy?

Virtual colonoscopy (VD) is more comfortable than regular colonoscopy since no colonoscope is inserted into the colon. In addition, VC is a faster procedure, requiring no sedation, and the recovery time is minimal. The resolution of the images generated after VC are more detailed than those obtained with a barium enema, and a VC is more likely to detect colorectal polyps than tests of stool samples (feces).

Q: What are the disadvantages of a virtual colonoscopy?

The doctor cannot obtain tissue samples or biopsies with virtual colonoscopy. If any masses/polyps are detected with VC, you must have a regular colonoscopy as the next step. Also, a VC can’t detect polyps smaller than 5-7 mm. It is important to understand that virtual colonoscopy has not replaced conventional colonoscopy, but is an option for individuals who do not want to undergo a regular colonoscopy, especially as an initial screening.

It is best to consult with your doctor and begin with the least invasive and most readily available test first. Some physicians recommend that you begin with a barium enema as an initial screening, so speak with your doctor about what may be best for you, what is available, and what is covered by your insurance.

To read the complete selection of questions that our experts have answered regarding virtual colonoscopy, please visit http://www.scandirectory.com/content/virtual_colonoscopy.asp

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