Virtual colonoscopies vs. colorectal exams: What are options in Connecticut?

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by Cheryl Jones

Created on: February 23, 2009 Last Updated: March 05, 2009

It's easy to find excuses to put off your colon cancer screening: it's uncomfortable even painful, it requires unpleasant laxatives the night before, and sedatives are usually administered, which may need hours to wear off.

But ignoring your colon screening test at age 50 can be serious. Colon screening detects polyps, or abnormal growths in the intestinal wall, and other intestinal diseases in the early stages. If untreated, polyps may become cancerous. Colon cancer is the second leading cause of death in the US and the third most commonly diagnosed cancer. The good news is regular screening can detect colon cancer in the early stages.

During a colonoscopy, a long, flexible, lighted tube is inserted through the length of the large intestine, or bowel. A small camera transmits images of the intestinal wall to a computer screen. Polyps, if detected, can be removed during the colonoscopy.

Colonoscopy is uncomfortable. The bowel must be cleansed with laxatives the night before, and sedatives and occasionally pain medication are given during the procedure. The sedative wears off after 30 to 60 minutes and patients remain in the clinic for up to 2 hours. It is common to feel cramping or bloating.

A new procedure called "virtual colonoscopy" or colonography reduces the discomfort and time associated with conventional colonoscopy. Instead of inserting a camera into the intestine, virtual colonoscopy uses CT or MRI technology to take hundreds of cross-sectional scans of the intestine. Although bowel prep with laxatives is still required, no sedation is necessary and the entire procedure takes 10 to 15 minutes.

During virtual colonoscopy, a small, thin tube is inserted a short way into the rectum and carbon dioxide gas is used to expand the intestine to for better visualization. The patient is then moved through the CT or MRI scanner, which constructs the cross-sectional images into a 3-D model of the inside of the intestine.

The image generated with virtual colonoscopy is clearer than with the conventional procedure, but virtual colonoscopy misses the smallest polyps that conventional colonoscopy can detect. And if polyps are found with virtual colonoscopy, a second procedure must be scheduled to remove the growths.

Because virtual colonoscopy uses newer technology, it is not available at all centers. Also, many health insurers, including Medicare, will not pay for the procedure.

Gastroenterologists consider conventional colonoscopy the "gold standard," but they recognize the importance of a more comfortable, less intrusive alternative. Virtual colonoscopy eliminates many of the excuses for neglecting your colon screening test.

Colonoscopy Clinics

Connecticut Surgical Group, Farmington

Danbury Hospital, Danbury virtual colonoscopy offered

Digestive Health Specialists, Meriden

Endoscopy Center of Fairfield, Fairfield

Gastroenterology Associates, Stratford & Southport

GI Health Specialists, Trumbull

Hartford Hospital, Hartford virtual colonoscopy offered

Middlesex Gastroenterology Associates, Middletown (main office), Essex, Madison, & Marlborough

Middlesex Hospital, Middletown virtual colonoscopy offered

New Milford Hospital, New Milford

University of Connecticut Health Center, Farmington