http://story.news.yahoo.com/news?tmpl=story&u=/kpix/20040401/lo_kpix/9626
Dr. Kim Mulvihill
Wed Mar 31, 9:13 PM ET
The prospect of a colonoscopy -- where a thin, flexible tube is inserted into the rectum and threaded up the intestines -- can leave some people unwilling to get screened.
"We need another screening tool," said Dr. Judy Yee of UCSF and the San Francisco VA Medical Center. "One that is appealing and acceptable to the patients, and I think that virtual colonoscopy is that tool."
Yee says the virtual colonoscopy is faster, safer, and much easier on patients. The technique is non-invasive, using a CT scan to generate a 3D view inside the colon.
I decided to see for myself. With no symptoms, family history, or other risk factors -- except getting older -- I'm considered at average risk for colon cancer and a perfect candidate for the virtual procedure.
The first step was cleaning out my bowels.
"One of the biggest pitfalls when we're interpreting virtual colonoscopy is residual solid material that's adherent to the colonic wall," Yee said.
So I had a few days of prep: two days of a low-fat, low-fiber diet, followed by clear liquids, barium, then gastrograffin to tag any leftover material. Next was magnesium citrate.
"It's also a saline cathartic, and it draws fluid into the bowel and helps you to evacuate," Yee said.
By dawn, it was time to get scanned. Unlike the traditional colonoscopy, there's no IV and no sedation -- just a slim tube gently pumping carbon dioxide gas into my colon to keep it open. It takes just minutes to complete. All in all, a piece of cake. Then, we're off to a virtual tour of my colon.
"The Endoluminal fly-through simulates what you would see on a colonoscopy. Now I'm looking for anything protruding and here is a suspect potential lesion," Yee said.
A potential lesion or polyp, almost 12 millimeters in size. With a virtual, less than eight percent of lesions will turn out to be false alarms. I'd rather be safe than sorry.
"If this were a true polyp of this size, the typical procedure would be to perform a sigmoidoscopy or a colonoscopy and perform a polypectomy," Yes said.
Because of the location of the suspect polyp, the next step is an invasive procedure called a sigmoidoscopy. There is a risk of bleeding or punching a hole in my colon. But first, once again, I have to clean my bowels.
In this case, the prep lasts only one day, but it's grueling. I drink a glass of a salty solution every ten minutes until the gallon is gone. It was a long night, but the salty brew did its job. After a little IV sedation, we were looking inside my colon through a flexible sigmoidoscope. It's good news -- there's no polyp.
Without a doubt, the virtual procedure is much easier. But there is always a chance of needing a second, more invasive scope to remove a polyp or prove it's just a false alarm.