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Questions Frequently Asked by Patients
Questions regarding Virtual Colonoscopy
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Question #1: | What is Virtual Colonoscopy? |
| Virtual colonoscopy is a FDA approved, non-invasive procedure, which screens for colorectal cancer. Virtual colonoscopy uses a state-of-the-art simulation program to reconstruct abdominal computed tomography (CT) images into a three-dimensional (3D) replica model of the colon. A radiologist, with advanced training, uses the 3D simulated images to navigate your colon in order to identify tumors and pre-cancerous polyps. The radiologist is also able to identify other abnormalities outside of the colon from the abdominal CT scan.
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Question #2: | Who should have a Virtual Colonoscopy?
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American Cancer Society recommends colon cancer screening for both men and women over the age of 50. For those individuals with a positive family history of colon cancer (family members such as father, mother, brother, or sister), the American Cancer Society recommends colon cancer screening starting at the age of 40. Currently, there are several screening methods available but optical colonoscopy (also known as “conventional" or “traditional" colonoscopy) was the only option available for full colon screening exam. Virtual colonoscopy can visualize the entire colon and it is a convenient, non-invasive screening procedure that makes it easy to protect yourself from colon cancer. In addition, virtual colonoscopy is a good alternative for patients who have a history of incomplete optical colonoscopy, are allergic to IV sedation, or are hesitant to get screened because they perceive optical colonoscopy as invasive, risky, time-consuming or inconvenient.
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Question #3: | How accurate is virtual colonoscopy compared to conventional colonoscopy?
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A recent clinical trial conducted at Walter Reed Army Medical Center-Washington, D.C., National Navy Medical Center-Bethesda, MD and Navy Medical Center-San Diego, CA concluded that virtual colonoscopy is slightly more accurate than conventional colonoscopy in detecting significant colonic polyps. This study was published in the New England Journal of Medicine in 2003. 1,233 screening patients for colon cancer were recruited and each patient underwent first virtual colonoscopy and within two hours underwent optical colonoscopy to compare results. The study compared the percentage of polyps found by both virtual colonoscopy and optical colonoscopy. See chart below:
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Polyp Size Threshold
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> 6 mm
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> 8 mm
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>10 mm
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Virtual Colonoscopy
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88.70%
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93.90%
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93.80%
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Optical Colonoscopy
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92.30%
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91.50%
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87.50%
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Patient questions about the prep
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Question #1: | Which pharmacies carry the prep set?
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The Virtual colonoscopy prep set is available through the following outpatient pharmacies:
Brooke Army Medical Center
Outpatient Pharmacy
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Question #2: | Why is it necessary to take prep medications?
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Virtual colonoscopy requires medications that clean out the colon and tags (highlights) stool. Without the proper medication to clean out the colon, remaining stool would make it difficult to view the colon wall. It is also important to take oral contrast, which is a tagging agent. Oral contrast will help the radiologist tell the difference between polyps and any remaining stool. It is important that these medications are taken exactly as instructed so that the most accurate and reliable reading is obtained. If the prep is done incorrectly the exam may have to be repeated.
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Question #3: | What medications are prescribed for this procedure?
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There are two types of prep kits available for virtual colonoscopy. For most patients the Fleets Phosphosoda prep kit should be used. This kit includes four medications: CT Barium, Gastroview, Dulcolax, and Fleets Phosphosoda.
Some patients should NOT take Fleets Phosphosoda as the laxative. Patients with a history of severe heart disease, kidney disease and other serious debilitating diseases should talk with their primary care provider about the side effects of Fleets Phosphosoda. A second prep kit was designed, specifically with these patients in mind and includes three medications: CT Barium, Gastroview, and Colyte.
CT Barium and Gastroview are oral contrast agents that are used in radiographic studies. Dulcolax pills are stool softeners, and Fleets Phosphosoda and Colyte are oral laxatives that promote bowel movements. All of these medications will work together to cleanse and tag your colon, making the detection of significant polyps and other abnormalities easier.
Note: If you have a history of severe heart disease, kidney disease, and/or other serious debilitating disease and believe you have received the wrong medication please contact our office before starting your prep.
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Question #4: | Will any of the prep medications interact with any health problems I have?
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There are two prep kits available. Depending on your medical history your primary care provider will prescribe the correct prep kit. If you have a history of kidney disease, severe heart disease, or are currently under a physicians care please discuss with your primary care provider which prep kit would be right for you. If you have any questions or concerns please contact the Virtual Colonoscopy Center before you start the prep.
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Question #5: | Do I need to stop taking any medications prior to the exam?
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You should continue to take prescribed medications as you normally would. This procedure should not cause you to miss or skip doses of your daily-prescribed medications. **Do NOT skip your blood pressure or heart medications** If needed, you can take over the counter medications such as aspirin, Ibuprofen (Motrin), and Acetaminophen (Tylenol). Avoid taking your regular medications within 2 hours of your virtual colonoscopy prep medications to avoid absorption issues.
If you normally take pills orally for diabetes twice a day, on the day prior to your exam take the AM dose but skip the PM dose. You will be on a strict clear liquid diet and you will not need to take the PM dose. On the morning of the exam, wait to take your AM dose after the exam is completed and once you start eating regular solid food again. If you normally take one pill orally for diabetes once a day, on the day prior to your exam take the dose in the morning. On the morning of the exam, again, wait to take your pill for diabetes after the exam is completed and you are back on a regular diet again.
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Patient questions about the procedure
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Question #1: | How is the virtual colonoscopy procedure performed?
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You will be asked to use the restroom right before the exam to insure your bowel is as empty as possible. You will be then asked to change into a hospital gown. You will be instructed to lie on your side on the CT scanner table. A trained technician will place a short, flexible, lubricated tube into your rectum. Through this tube a CT technologist or radiologist will distend and fill your colon with room air so that it is distended enough to get an accurate reading. Every patient will receive different amounts of air depending on how large the colon is. You may feel some discomfort from the distention. Most patients rate the level of discomfort as “tolerable" and most of the discomfort is immediately relieved as soon as the procedure is completed.
The CT scanner will then take pictures of your abdomen. During the scan you will periodically need to hold your breath for several seconds. Pictures will be taken while you are lying on your back and on your stomach. When you lay on your stomach you should feel significant relief from the abdominal pressure. The procedure from start to finish should take no longer than 15 minutes. You will be asked to use the restroom right after the exam is completed and to then change back to your clothes. You will be instructed to go back to a regular diet and to your normal schedule. There is no recovery period so you can leave right after the exam. After the CT scanner compiles the images, they are then sent to a computer that uses 3D technology to recreate your colon into a computerized 3D replica. A trained radiologist will interpret the 3D image of your colon as well as the abdominal CT scan to detect significant polyps and other abnormalities.
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Question #2: | Is the procedure painful?
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Since the procedure uses a non-invasive technique, most patients do not feel any severe pain. Most patients describe the discomfort as feeling “bloated" Some patients may feel cramping similar to gas pains. If present, the “gas cramping pain" lasts about 3-4 minutes and subsides once the manual pumping of room air stops. The “bloated" feeling should pass within 30 minutes and leave no lasting effect.
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Question #3: | When and where should I arrive for the procedure?
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You will be asked to arrive at least one hour prior to your appointment time to take the last dose of Gastroview, which has a laxative side effect. You can bring your own juice to chase it with or use our vending machines. Restrooms are available near the waiting room. When you arrive, please inform the front desk of your name, time of appointment, and ask for a patient history form and the virtual colonoscopy information sheet.
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Question #4: | Will I need someone for transportation to and from the exam? When can I resume normal activities?
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Virtual colonoscopy requires no sedation, so you do not need someone to drive you to or from the exam. After the exam there is no observation or recovery period, and you can resume your regular daily activities.
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Question #5: | When and how will I find out the results of the exam?
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After a trained radiologist interprets the exam, your referring physician will also be notified of the results. Your physician will receive a full color report detailing the findings and recommendation from the exam within 3 business days of your exam.
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