Ask Dr. Beck

Dr. Beck is board certified in general and colon and rectal surgery and is a Clinical Professor of Surgery at Vanderbilt. Dr. Beck conducts research into colorectal diseases, has authored and edited nine medical textbooks, and written over 350 scientific publications. He was the President of the American Society of Colon and Rectal Surgeons (ASCRS) from 2010-2011. Dr. Beck is a nationally recognized expert in inflammatory bowel disease, anal, rectal and colon cancer, stomas, adhesions, bowel preparation, sphincter saving surgery for cancer, laparoscopic surgery, and postoperative pain management.

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Colonoscopy Alternative

I cannot get my “inactive” colon cleaned out well enough for a colonoscopy, so I had two aborted attempts. Is there an alternative (like CT scan or blood test) that provides enough information to determine the existence of cancer?

Colonoscopy remains the “Gold Standard” and there are several additional ways to get your colon “clean.” Other than colonoscopy, there are other options to evaluate your colon. Radiologic tests include barium enema (a test where a contrast liquid is inserted into the bowel and X-ray pictures are taken), CT colonography (computerized x-ray exam that uses air as contrast and is sometimes inaccurately called a virtual colonoscopy) or a MR colonography (an exam that uses magnetic waves and air contrast with a computer) to produce a picture of the colon. Each of these tests has advantages and limitations – they essentially take a picture of the colon and its contents. None of these tests are good for small polyps or growth (less than 1/4 inch) and if a larger growth is seen, another test like a colonscopy may be necessary to make sure the object identified is not a piece of stool.

Other tests look at the stool for the presence of blood (Guiac or FIT test) or abnormal DNA (Cologuard). Neither is much help if there is no stool coming out of your colon. Also, cancers don’t always bleed or shed abnormal DNA and there may be noncancerous causes for the blood. The tests also don’t localize the location of the abnormality to a portion of the colon. These tests are usually 70-90% accurate. And again, if these tests are abnormal, a colonoscopy may be indicated. Due to the accuracy mentioned previously, few surgeons would consider an operation based solely on these tests.


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