While conventional colonoscopy is still considered the "gold standard" in the diagnosis of colorectal cancer and its precursors, many patients avoid the test because of the need for cathartic colon cleansing," says Philippe Lefere, MD, of Stedelijk Ziekenhuis, Roeselare, Belgium, and lead author of the study.
The process of cathartic cleansing regularly used for conventional colonoscopy requires patients to drink "4-5 liters of a suspension known as polyethylene glycol, which has a very bad taste," says Dr. Lefere. "This produces massive diarrhea that empties and cleans the colon--but makes the patient feel sick and exhausted."
In an effort to improve compliance by making CTC more comfortable for patients, Dr. Lefere and his research team studied nine patients. Each of the patients ingested barium – groups one and two were given different concentrations of barium over a one-day period; group three ingested barium over two days. The barium effectively "tagged" fecal matter left in the colon, says Dr. Lefere.
In addition to taking barium, the patients were also placed on low residue diets and reduced-hydration regimens the day prior to undergoing CTC. By restricting food and liquid intake, Dr. Lefere says fecal volume was reduced and the colon was almost completely dry in each patient--conditions that make it easier to detect polyps.
"Our results suggest that CTC can be done without cathartic cleansing," says Dr. Lefere. "Some gastroenterologists say that if CTC could be performed without cathartic cleansing, it would have all the chances of becoming the screening method of choice." If this method of CTC proves to be an effective screening tool, Dr. Lefere says, "the main barrier for the patient coming to the examination would be eliminated."
Dr. Lefere says he and his colleagues have also tried to reduce the volume of barium to be ingested. While it is still a work in progress, Dr. Lefere says the results are looking very promising. His colleagues include Stefann Gryspeerdt, MD, Marc Baekelandt, MD, and Bartel Van Holsbeeck, MD.
The study will be presented May 7, during the American Roentgen Ray Society Annual Meeting in San Diego.
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