Barium Enema vs. Colonoscopy
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I've had both.The colonoscopy was done with anasthesia, at the GI's office. So you don't feel anything at all. The preparation can be nasty but not for us IBS-C people! Because it makes you go! Different doctors/hospitals have different "colon preps", usually a combination of stool softeners and stimulant laxatives. Afterwards you might have some gas but nothing hurts before, during or after.During this test the specialist is looking inside your colon, checking how the tissue looks, and any other strange stuff, and also will take out any polyps he might encounter.The barium enema was done at the hospital, no anasthesia. I requested the watersoluble one (was afraid I would never expel the regular barium) and basically it is an enema, they put the tube in your rear end and pump in stuff, then plug it, ask you to move here and there and take x-rays. Then you are "unplugged" and run to the bathroom and it is over. Not exactly painful, yes very very uncomfortable. This test allows for an "x-ray" for this organ and can tell the doctor if there is a twist or loop or things like that.If the doctor or specialist has recommended you have them I would go ahead.
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Neither test will prove you have IBS. They do not look for the things that are screwed up with IBS.Barium is better for larger anatomical things. It can see some tumors or polyps but they then have to do the colonoscopy afterward.When crohn's/colitis is mild enough to just effect the lining of the colon you may not see it on the barium, but if it is severe enough to disrupt the anatomy a bit more you can see that. You also can see things like loops in the colon or diverticuli (out pouchings).Generally with crohn's or colitis you will see bloody diarrhea and abnormalities in your blood work.
Don't ever do virtual colonoscopy.It is a CT (CAT) scan which is a huge doseof radiation. In fact, one virtual colonoscopy is the same as 1,500 dental x-rays or 1,500 x-raysof your arm.Barium enema can be for many things. Do you not know what your doc is looking for?Another alternative is capsule endoscopy (CE.)CE is a pillcam (camera) that you swallow; it takes2 pictures every second in 8 hours (55,000 pictures.)You wear a small computer around your waist and afteer 8 hours, you're done.You just have to prep for one day but all procedures requireprep.
Sun IBS is a diagnosis of exclusion just so you know. All other GI diseases and/or disorders are attemped to be ruled out before an IBS dx is reached. Most Docs usually want to try to do a colonoscopy because it is a quick way to rule out quite a few other things at once.See the comparative chart on our "Symptoms" tab up there in the white menu bar and have a look at the other diseases listed for an idea of some of the things they want to rule out.
BQ, IBS is no longer a diagnosis of exclusionever since ROME III criteria and a series ofquestioning about past experiences.But I understand your point. But this physician askingher to undergo barium enema is not sufficient as thistest alone will not do what a colonoscopy or capsuleendoscopy can. That's why I asked, what is he lookingfor. The best combo is SBFT (small bowel follow through) and capsule endoscopy. SBFT should be first as one needs to assess the presence of stricturing to prevent capsuleretention as capsule retention occurs in 1 to 4% of thosewith suspected or known Crohn's disease. While SBFT is flouroscopy and a heavy dose of radiation itis 70% less radiation than virtual colonoscopy.
Artlady,Ask you doctor for a SBFT (small bowel follow through)combined with capsule endoscopy. If you want the least amount of radiation, ask for a MR-enterography combinedwith a capsule endoscopy. MR-enterography is an MRI so it does not contain any radiation.
No Sun it really is typically still done by ruling out other GI diseases and disorders in addition to some questions.Here, some info for you:http://www.ibsgroup.org/diagnosisI imagine since she has difficulty with anesthesia her Dr. is looking for what he can look for with the limitations of a BE. Like Kathleen said.. a BE can find the larger abnormalities. Of course it isn't sufficient but.. maybe that is just where he will start. I don't know.. perhaps Art Lady will tell us.Art Lady here is some info on Medical Tests:http://www.ibsgroup.org/testsAnd specifically here is some info on the Barium Enema test:http://www.nlm.nih.gov/medlineplus/ency/article/003817.htmFrom what I have read from others there is some perhaps some uncomfortable moments when they put the air in... but most report it is a brief time only.I would try to relax a bit about any testing. Usually the anticipation is worse than the event. And many folks have been through them before and lived to tell the tale and you will too!
BQ, all the top scientists studying GI disordersand the top GI specialists as well as the top colo-rectalsurgeons no longer call this a diagnosis of exclusion.They came up with this phrase over 20 years ago becausethey (most of the medical community) viewed IBS an entitythat is not classified as a disease. If anything, they viewed itas a mental disorder. So they check for all the diseases and then when they can't findother disorders (Crohn's, colitis, cancer, etc) they label it IBS.For anyone to refer to this disease as a a diagnosis of exclusionis unfortunate and a disservice to anyone who has IBS or anyof their loved ones as well.Diagnosis of exclusion means no set criteria. But within the last10 years there is set criteria.Let me know if you want papers, reviews, studies, that refer to it being no longer a diagnosis of exclusion. I can list them here.
I think you don't agree simply because this the phrase you havebeen using for 10 years.I understand it is difficult to change after ten years.But I would posit that even 20 years ago there wasenough information to classify IBS as its own disease.The medical community views anything that can't berepaired by a drug and/or surgery as folly. Thisis why they refer to it as a diagnosis of exclusion.This is the case because the other diseases thatcould be caused by diarrhea are real while IBS is not.Now family physicians and some old school GIs stillcall it a diagnosis of exclusion but Harvard medical school and the top medical schools are quick topoint out that this disease is no longer a diagnosisof exclusion. Again, the top GI specialists state thesame. It's a disease with criteria. Period. One can spot this noweven without doing a colonoscopy. If someone comes into a physician presenting with persistent diarrhea, physiciansmay not need the full work up to diagnosis this disease. Technicallythey do for legal purposes (defensive medicine) but in reality theydo not.For example, someone with persistent diarrhea for 10 yearsprobably does not have cancer or salmonella poisoning. Crohn's or colitis is possible but in theory ones does not need5,000 dollars worth of medical tests to determine this.It's unfortunate that even they very people that suffer with the diseaseare caught up in the idea that it is not a real disease. By simply referringto it as a diagnosis of exlclusion is falling into that trap.
Here's one, I can list more if you need further convincing.http://www.ncbi.nlm.nih.gov/pubmed/14602054
I had asked you start your own thread with this info. Do you see how to do that by clicking on "New Topic" just above on the right? That's what you click on to begin your own new thread.As far as that saying it isn't a "diagnosis of exclusion".. for intents and purposes... it is largely still a diagnosis reached via ruling out other diseases and disorders.Now unless you have anything else to say to Art Lady here.. PLEASE start your own thread.Thank You.
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If you look under people names you will notice some people are moderators, and part of the job to make requests about how/where people post and sometimes even move posts if they are in the wrong section, etc.Were you unaware this is a moderated board?
Hahaha....I knew the website is moderated and I thought youwere the moderator. Until you mentioned it I did not knowBQ was one nor did I assume there are multiple ones.That does explain his/her attitude but I still don't understand it.Well I guess his motivation to tell me what to do was influenced inpart by me challenging his longstanding belief of diagnosis of exclusionas this discussion is still related to the topic at hand.
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We have historically had issues with people getting off the main question and off into whatever theoretical argument is their particular thing.Sometimes those more arguementative posts are less supportive than directly dealing with just the particular question at hand.Even with the newish blood test that can rule IBS in rather than just rule other things out, most of the diagnosis once they check off the symptoms (which are found in a lot of illnesses to one degree or another) is making sure it ain't something else. Other than the blood test, nothing else "sees" IBS. How typical your symptoms are or sometimes which particular glitches you have will determine the other tests needed.For constipation I'm usually more interested to see if those that strain a lot get pelvic floor testing (which a lot of people never get) than checking out the small intestine for problems. But that is my thing, so back to the topic at handIf you can't tolerate sedation either the barium enema or the virtual colonoscopy will visualize the whole colon. Not much else does. Usually the worst CT scans are the whole body ones. By limiting how much of the body they do reduce the total radiation dose and you do need to look at what kind of body burden you have. I've you've never had a lot of X-rays and don't fly a lot you may have the "room" for it.
I have had both barium enema and colonoscopy.I whole heart recommend the colonoscopy.The barium enema is horrible. Even though its sounds a better option the colonoscopy is the one to go for. Dont bother with a virtual colonoscopy for the reasons above.
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