Virtual colonoscopy anyone?

  1. I am 52 y.o. with family hx of deaths from colon caner (i.e. father died at age 53.) I've had colosnoscopies 3 times for the past decade or so. Last one,despite efforts of the GI, was totally unbearable. He even used a Pediatric scope. The meds were the typical one-Demerol and Versed.
    No amnesia for me here!!! I've read a few of the posts re Propofol.
    My question here is- have folks read from patients about the Virtual Colonoscopy?I know my insurance won't pay for it, but it might be worth it in the "pain" department for me. Do you know if,in general,it's less painful?? I know of some of the research re accuracy-some places indicate a greater accuarcy,some a lesser accuary. But my main question is_ Is it less painful?
    (By the way, the speculation of some of the docs is -"Perhaps it the endometriosis adhesions causing the pain... maybe it's the torturous bowel>"
    But colonoscopies have always brought werious, sever pain for me.
    At any rate, I'm not going to have another colonoscopy with just Demerol and Versed. I'm also thinking that general asnesthesia is a bit drastic, but certainly I can see the merits of intubation with Propofol!!!
    But I MUST get the test due to family hx- so back to my question- Any less pain with the virtual colonoscopy.
    Thanks guys for reading this rant.
    •  
  2. 8 Comments

  3. by   kimtab
    The virtual colonoscopies are just not as accurate. You still have to do a bowel prep, and it's strictly diagnostic. If they find something you then need to undergo a regular colonoscopy. I wouldn't consider the virtual colonoscopy as a substitute if I were you.

    See if you can get propofol for your next exam. We don't intubate with propofol; but it is adminstered by an anesthetist who is there to manage your airway if the need arises. I would personally never consider general anesthesia for a procedure like this, and I'll bet your doc would be pretty reluctant to do it as well.

    I would also question...has it been the same doc doing the colonoscopies all times? Getting around a colon with a scope does take quite a degree of finesse, especially if you have an anatomy that is challenging. Maybe a doc with better technique can get by with just demerol and versed. Ask around.
  4. by   spaniel
    Thank you for your reply. I've had a total of three colonoscopies. the ifrst wasoh I believe about 14 years ago- that was the least painful of the 3. The last two were terrible. All three were done by different doctors. Yes, Propofol WITH the anesthetist right there might be an idea.
  5. by   krisssy
    Hi Spaniel,


    I accidently came across this old post. I had two colonoscopies a year apart from each other. Both times, they could not get all the way through, because I have a long torturous colon. Two different doctors tried. After the second colonoscopy, I was diagnosed with a prolapsed retum requiring a major colectomy and resection. So I had to have a Virtual Colonoscopy in order for them to see the top part of my colon before surgery. I felt no pain at all with the virtual. It is like having a CT scan. You just go under a machine, they take a picture, and that's it. I think they put something in me through IV in order to see the picture. But you are up, and it is totally painless. I would find another doc to do a regular colonoscopy. With Fentynal and Versed, I was asleep-didn't know what was happening-felt nothing-sleeping. Maybe your doc didn't give you enough of the latter. Krisssy
  6. by   caroladybelle
    Virtual colonoscpies only give visualization of the colon, they do not permit biopsies. And in most cases, the MD will want biopsies because of accuracy.

    Try propofol. It worked beautifully for my last scope.
  7. by   GI Jackie
    I know this an old thread but I just had to answer. Along with the whole you have to prep just the same anyway argument, I have another concern. We recently had a pt that had severe diverticulits and were unable to pass the scope beyond 30 cm. Our doc wanted him to have a virtual and follow up with him in the office in one week. We were able to get him in that same day to have a virtual colonoscopy and then he followed up in the office. The virtual showed diverticum and thickening at that location. He had a follow up colonoscopy one month later after antibiotic treatment. We were able to complete the colonoscopy at that visit and he had a large polyp that did not show on the virtual. We took it out and it was benign, but what if he just took the word of the virtual and pressed on. That was enough for me to say that the technology is not there yet to replace traditional colonoscopy. Besides you don't get to nap during the virutal--yuck!
  8. by   krisssy
    Quote from GI Jackie
    I know this an old thread but I just had to answer. Along with the whole you have to prep just the same anyway argument, I have another concern. We recently had a pt that had severe diverticulits and were unable to pass the scope beyond 30 cm. Our doc wanted him to have a virtual and follow up with him in the office in one week. We were able to get him in that same day to have a virtual colonoscopy and then he followed up in the office. The virtual showed diverticum and thickening at that location. He had a follow up colonoscopy one month later after antibiotic treatment. We were able to complete the colonoscopy at that visit and he had a large polyp that did not show on the virtual. We took it out and it was benign, but what if he just took the word of the virtual and pressed on. That was enough for me to say that the technology is not there yet to replace traditional colonoscopy. Besides you don't get to nap during the virutal--yuck!
    Well , the virtual colonoscopy did serve the purpose of seeing the thickening and treating with antibiotics so they could then go back and go all the way up with a reguular colonoscopy. Personally, I agree with you that the regular colonoscopy is the way to go. But sometimes there is a need for a virtual colonoscopy in certain cases. As I said previously, in my case I had had two regular colonoscopies a year apart. Both times they could not get all the way through due to a long torid (sp?) colon . Two doctors had tried. The second time, I was diagnosed with a prolapsed rectum and needed a partial colectomy to repair it. All the surgeons I went to would not do the surgery without seeing what was all the way up there. So that is why I had it done. But in five years when I go for my next one, it will be the regular one. I am hoping that with the partial colectomy and a shorter colon, they will now be able to make it all the way up. But certainly for a person without a problem, I would advise just enjoying the sleep and having it the regular way. Also, if there is a polyp, they can't remove it right away with a virtual, and you would have to have the other kind anyway. The thing I would not do is have the regular procedure without anesthesia-to me that is crazy! Krisssy
  9. by   spaniel
    Thanks for your reply. I have read so often that the degree of diagnostic capability rests a great deal on where/who does the reading of the virtual colonoscopy. Does anyone know of a place in the NorthEast that has a super reputation for the VC? ??Brigham and Women's (Harvard)... NYU?...
    I actually think my last doc really did try to make things more comfortable-it just didn't work, though he technically completed the test, or so it was said.
    This was the traditional colonoscopy with and versed. I did call his office back and they do Propofol with a CRNA. I think one would be nuts to have one done without the anesthesia backup. I happen to know that I'm a hard intubation to boot!!
  10. by   krisssy
    Quote from spaniel
    Thanks for your reply. I have read so often that the degree of diagnostic capability rests a great deal on where/who does the reading of the virtual colonoscopy. Does anyone know of a place in the NorthEast that has a super reputation for the VC? ??Brigham and Women's (Harvard)... NYU?...
    I actually think my last doc really did try to make things more comfortable-it just didn't work, though he technically completed the test, or so it was said.
    This was the traditional colonoscopy with and versed. I did call his office back and they do Propofol with a CRNA. I think one would be nuts to have one done without the anesthesia backup. I happen to know that I'm a hard intubation to boot!!
    Spaniel,

    My last colonoscopy was done with Versed and Fentanyl. I went to sleep and did not feel a thing. After two wrong diagnoses of Ulcerative Colitis, this doctor finally correctly diagnosed it as a prolapsed rectum which was what it was. Before the surgery, the surgeon said I had to have a virtual, because as I said, they could not get all the way up. My sister and I have long winding colons, and it is impossible to go all the way up. The virtual just showed that nothing was wrong on the top part.

    The Dr. that did a painless Fentanyl and Versed colonoscopy and correctly diagnosed me is located in Great Neck NY. on Long Island. If you want a recommendation, PM me, and I will give you his name and number. I would be happy to recommend him. He does the colonoscopys with an anesthesologist. I can't really remember if it was an MD or PA or CRNA-just that I enjoyed a peaceful sleep! -NO PAIN at all Krisssy

close