FIRST PERSON | Boston researchers have reported a new technique to make undergoing a colonoscopy much less difficult. Their results suggest that laxative-free virtual colonoscopies are effective in locating high-risk polyps. For patients who have to have this radiographic study on a regular basis -- perhaps even every year -- the laxative in the preparation sometimes proves more troublesome than the procedure itself.
My gastroenterologist uses a colonoscopy to see what's left of my small intestine after repeated surgeries to remove parts of it due to Crohn's disease. Since this condition sometimes also occurs in the large intestine, colonoscopies on patients with this disorder are a common diagnostic technique, according to the Crohn's & Colitis Foundation of America.
I've had two in two years. My doctor, like a number of gastroenterologists, has reservations about the accuracy of results from a computerized, or virtual, colonoscopy. As a result, I always get the traditional procedure.
Because I have lost so much of my small intestine and a portion of my colon, the laxative portion is almost unbearable, even with a so-called "lite" product. I have to use the restroom every five minutes for hours on end. I get nauseated and bloated. Sometimes I vomit. I needed to go to the bathroom every half hour for two days after my recent colonoscopy and had to cancel plans for both days.
Two years ago, my doctor discovered a medium-sized adenoma during my colonoscopy. An adenoma, which is also known as a colon adenomatous polyp, is a benign structure. Usually slow-growing, it's still worrisome because it can signal changes in the lining of the intestine leading to cancer. I ended up with more frequent colonoscopies as a result of the discovery.
Findings of the researchers at Massachusetts General Hospital appeared in the Annals of Internal Medicine. The goal of their study was to determine the diagnostic accuracy of finding adenomas at least 6 mm in size and evaluating patients' experience using computer-aided computed tomographic colonography (CTC) without any laxative preparation.
The study followed 605 adults between 50 to 85 years old considered at moderate risk for developing colon cancer. The Boston researchers found that for adenomas of 10 mm or larger, the laxative-free CTC results were comparable to those from traditional colonoscopies, the hospital says.
Patients in the Massachusetts study also completed written surveys. They considered the laxative-free procedure more comfortable, with an easier overall preparation, than a traditional colonoscopy. More than 60 percent of them said it would be their preferred screening method.
The researchers are quick to point out the need for larger clinical trials. Should those studies produce similar results, they believe the laxative-free CTC could have a significant impact on diagnosing colon cancer and reducing deaths from the disease.
Vonda J. Sines is a health and medical writer who has published thousands of print and online articles. She is also a founding member of a chapter of the Crohn's & Colitis Foundation of America.