[hasenfuss]

Last year my G.I doctor ordered a CT scan for my abdoman and pelvic are. I had to drink a big cup of Barium before that. He said, he is looking for inflammation, diverticulis and tumors. Everything was fine and my doctor didn't even suspect anything before that but he wanted to make 100% sure. He said a colonoscopy isn't needed in my case since I don't have any family history of colono cancer and I am only 36 years old . I did have a sigmoidoscopy alomost 3 years ago when my GI trouble started. I am just wondering why so many people have colonoscopies when a ct scan is so much more comfortable ? I am thinking sometimes my insurance doesn't want to do it because a colonoscopy costs maybe more than a ct scan ? The insurance is non-profit (Kaiser) in case anybody is familier with that. The only thing I can think of is that you can't take biobsis with a ct-scan. Are they doing biobsies only when they see something suspicious in the ct scan ? I am just trying to understand the whole thing. I hope I don't drive anybody crazy on that board with all my worries over the whole testing issue. It's always in the back of my mind.

 

[Kathleen M.]

Actually I think a CT scan is typically more costly than a colonoscopy.With "virtual colonoscopy" they end up doing a regular colonoscopy any time they see anything that needs to be biopsied or removed, so they can often end up paying for both.The CT scan will let you see other organs when the colonoscopy only looks at one. So sometimes they want a CT because they are worried it might be something other than the colon and they want to look at more than one thing at one shot.K.

 

[hasenfuss]

quote:Reply

KathleenSo do you think a ct scan is a better test than a colonoscopy ? Maybe a lot of people don't get ct scans because it is actually more costly ?

 

[Kathleen M.]

You have to match the test to the symptoms and what you think you need to look at.No test will always be better than some other test.Each test has its advantages and its limitations so you can't ever make a blanket statement that one should always get one vs another.Medical costs do sometimes play a role in things. There isn't enough money or equipment to do every single test on every single person. Besides a lot of extra tests usually ends up being bad for the patient because of the stress of testing besides the cumulative risk of testing someone over and over and over again.These tests are not risk free. Certain tests have more risk that others, so some tests are only done when getting the answer is worth the chance you will cause a problem. CT scans involve radiation which in excess can be problematic, colonoscopy has a risk of perforating the colon. These risks are part of the equation as to which tests you do on which patients.K.

 

[16963]

I had both, but I had my colonoscopy first which makes me think that maybe that's usually more helpful in diagnosing.

 

[Jasmine523]

I had both.My Primary Care Doc ordered the CT scan first.The first test my GI did was a colonopscopy ~ which he was checking for IBD and polyps and stuff.The colonopscopy was not as bad as I thought. I was put to sleep. The worst was the prep the day before (and it wasn't horrible as I had been eating light the few days before)

 

[Jasmine523]

Oh, and I think my PC said the CT was usefull in viewing all of the organs, but not what was going on 'inside' of them. Or something like that.Like my CT showed normal in the gastro dept, but showed enlarged uterus w/fibroid and an ovarian cyst.

 

[eric]

hasenfuss We of course can diagnose you here, but from your past posts, what you have posted is consistent with IBS.also fyi"Diagnosis of IBSAn occasional bout with abdominal pain and diarrhea or constipation is an experience nearly everyone has in common. People may view these symptoms as normal, even when they frequently occur. However, chronic and recurring symptoms are not normal. They may signal IBS. A doctor can provide a diagnosis.The diagnosis of IBS currently is based on a pattern of symptoms that fit established criteria, in conjunction with a detailed history, a physical examination, and tests that rule out other identifiable causes. However, there are no physical findings or diagnostic tests that confirm the diagnosis of IBS. Therefore, diagnosis of IBS involves identifying certain symptoms consistent with the disorder and excluding other medical conditions that may have a similar clinical presentation.The first step in making a positive diagnosis of IBS is for a doctor to identify if an individual has the symptoms of IBS. This is best determined by the use of the Rome Criteria, which is a collection of the most common symptoms that typify the disorder. These include abdominal pain or discomfort for at least 3 days per month in the last 3 months that is associated with two of the following: 1) the pain or discomfort is improved with defecation, 2) the pain or discomfort is associated with an increase or decrease in stool frequency, and/or 3) the pain or discomfort is associated with the stools becoming harder or softer in consistency.The next important step is to exclude signs and symptoms that are suggestive of a condition other than IBS which may present with symptoms similar to those seen in IBS â€" but with uniquely identifying features â€" such as inflammatory bowel disease or GI infections. A medical history and physical examination, laboratory, and GI tests can help to exclude these other diagnoses. Typical signs and symptoms the physician will look for include anemia and other abnormal blood tests, blood in the stool, unexplained weight loss, fever, and family history of inflammatory bowel disease or colon cancer. When these symptoms occur, they should be brought to the attention of a physician. These features can be a clue that another disorder besides IBS is responsible for the gastrointestinal symptoms and may call for further testing. However, a separate, benign problem is often found that explains the problem. For example, rectal bleeding with features typical of an anal origin that is reported by patients with an unchanged, chronic pattern of IBS symptoms is usually found to be caused by hemorrhoids.In summary, a knowledgeable physician can diagnose IBS by careful review of the patient's symptoms, a physical examination, and selected diagnostic procedures that are often limited to a few basic tests. Such a diagnosis is quite secure, as follow-up for many years of confidently diagnosed patients seldom discloses another cause for their symptoms. With an unequivocal diagnosis, both patient and physician can work together on the most effective management."http://www.aboutibs.org/site/about-ibs/symptoms/diagnosis

 

[hasenfuss]

Eric, Thanks so much for your responds. I know I need to calm down about my health anxiety over IBS. It's a little scary when I read stuff on this board. My symphtoms didn't get worse and on some days I actually feel about 90% o.k but it usually doesn't last long and when I feel pain I feel scared again. I don't really trust the health care system that much because I actually had to fight to get a referal to a G.I doctor. The first doctor was rude and said that most people don't even visit the doctor when they have IBS. I read that %70 don't visit the doctor. I am in the moderate range and just had to see one.

 

[eric]

In my above post I made a mistake. We can't diagnose you here. Just want to clairify that really.hasenfuss Are you working with that doc now?This is major, its important to treat that anxiety and worry, you will feel better if you do and it will help your IBS. You can view it seperatly from your IBS which is also common and treat it or even , view it as part of the IBS and you as a whole person. In IBS you have to treat the whole person, body and mind as they are not seperate and both contribute to the symptoms. This can help you from suffering longer then you need too.It can be difficult for some, but it can be done. It also doesn't happen over night but by slowly working on it and education about it all.I also want to mention, people can have internal hemmroids and IBS. Really your tests have been clear and the doctor has told you you have them and while bleeding from there is not good and worrisome its important not to overly stress yourself out about them. For me personally after over thrty five years of IBS, if another disorder "gets me" in the long run, well so be it and not much you can do about it except get checked out once in a while for any changes or red flags. On the flip side I worried some about what IBS could be, but also realized I couldn't worry even more everday for so many years when otherwise the doctors told me I was healthy. That can make IBS worse.psycho-physiological is how the body works chemically and electrically. Worry, fear, anger are just a few of the negative emotions that have negative and direct impact on digestion in IBS and makes IBS worse. Treating that you might find yourself going from moderate IBS to mild IBS. That could be a good goal no?

 

[hasenfuss]

Thanks Eric for you post. My G.I doctor was referring me already to the Behaviour medicine department because of my anxiety over IBS. I am seeing somebody (every 6 weeks) to talk about my IBS and also to monitor the antidepressents I am taking. Maybe I would be even worse without it. I can also e-mail my doctor sometimes but I am not overdoing that otherwise I am driving him crazy. Luckely there is the IBS board where I can also post my concerns. I did visit a class called "managing your anxiety" but in that class nobody had IBS and it was hard for me to talk about my condition in front of others. I hope one day I will have mild IBS. I am now paranoid of seeing blood in the stool and I am always wondering (because the sigmoidoscopy was 2,5 years ago)that something bad developed during that time. My G.I doctor said he sees his IBS patients every 6 months. It's hard to get him on the phone that's why at least I can e-mail him,

 

[eric]

I have forgotten, but are you in the US or UK?"I am seeing somebody (every 6 weeks) to talk about my IBS "That seems like a long time in between seeing them. I would think every week would be a lot better?Also this should be more then "just" talking but them teaching you relaxation skills etc.."antidepressents I am taking. Maybe I would be even worse without it."That's possible for sure. "I did visit a class called "managing your anxiety" but in that class nobody had IBS and it was hard for me to talk about my condition in front of others. "Totally understandable and nor should you have too. That wasn't the class for you. "Managing anxiety" was causing you even more anxiety."I hope one day I will have mild IBS"This is totally possible."I am now paranoid of seeing blood in the stool and I am always wondering (because the sigmoidoscopy was 2,5 years ago)that something bad developed during that time."You don't have other red flags along with the occasional bleeding that something else is going on and the blood has been brite red and the doctor has told you the cause, internal hemmies. You also have symptoms consistent with IBS from what you have posted."My G.I doctor said he sees his IBS patients every 6 months."Thats pretty common and better then some and good he lets you email him once in a while. You should read this excellent article on understanding anxiety as it might be helpful.http://www.time.com/time/europe/magazine/2...iety/story.html

 

[hasenfuss]

Thanks Eric for the article and your responds. I do like to see somebody every week but my Insurance (Kaiser ) doesn't offer that. When it comes to anxiety they send you to a class and give you medication. They tried to put a IBS support group together but it didn't work. Almost nobody came so they cancelled that group. By the way, I live in California near San Francisco. I am at least glad that I have the IBS support group on line so when I freak out I can always ask questions. I hope you are not too annoyed by my anxiety over IBS but thanks again.

 

[eric]

hasenfuss no worriesHave you tried here with the support group. I am not positive they are still going, but might be?"IBS Self-Help Group For San FranciscoWhen: The First Thursday of each monthTime: 6:00 PM- 7:00 PMPlace: St. Mary's Medical Center450 Stanyan St. San FranciscoCost: $10Contact: Womankind at (415) 750-5775

 

[hasenfuss]

Eric, I called the number you gave me but unfortunatly the IBS group is not happening anymore.