Colonoscopy vs. Virtual Colonography

[Jupiter]

I'm 50 years old in the San Francisco Bay Area and need either colonoscopy with that long fiberoptic tube or that virtual scan.

I was told that the scan is slightly more sensitive and less painful, but of course if something is found then one needs to do the regular colonoscopy.

1. Which test is more sensitive ?

2. Which one is least painful ?

3. Where is the best place in the SF Bay Area for that virtual scan ?

My other friend age 62 has had two normal colonoscopies, the last one about four years ago. Should he get the virtual scan for his next study ?

Thank you.

[John Kenyon, CNA]

Hello -

Neither type (virtual or true) is painful as a rule. If your friend, who has already had two, experienced pain (you don't say this, but I have to wonder), that would be very unusual. While a negative virtual exam is fairly sensitive, the true colonoscopy is more sensitive -- just about 100 per cent -- and allows immediate biopsy or removal of polyps, again, as a rule, without any pain during the procedure.

Both procedures require the same prep the night before, which is the only really annoying thing about either one, but if a virtual leaves anything in question, as you've mentioned, the true procedure still has to be done anyway, so unless you feel awfully lucky or have some specific contraindication to having a true procedure done, you're better off just having the true colonoscopy done. Post-procedural pain is very unusual, and periprocedure pain is almost unheard of anymore. Also, the actual true procedure only takes about 15-20 minutes, so the time factor isn't much different from a virtual.

There are a few people who have absolute or relative contraindications to a true colonoscopy, but these are few and far between. Pain is extremely rare. I'd go with the true procedure every time it was necessary rather than risk wasting the time of having to do it twice. That's just me, though.

I hope this is helpful to you. Please follow up with us as needed.