Many of us are very scared when we are asked to do a 'colonoscopy' test, right? Some people try to avoid this test for many reasons, such as the discomfort, pain, and fear of anesthesia when a camera is inserted into the body. But there is something we should not forget. That is, colorectal cancer is a disease that can be completely cured if detected early. So the best way to do it is to do this test. So avoiding this because you are afraid is not a good thing at all. Today, we are introducing a modern technology called 'Virtual Colonoscopy' as a good solution to that fear.
Simply put, what is this virtual colonoscopy?
A virtual colonoscopy is, to be precise, a special test that looks for small growths, or what we medically call 'polyps', inside your colon. These polyps are the ones that can turn into cancer over time.
This is not a procedure where a long tube is inserted into your body like a regular colonoscopy. Instead, it uses a CT scan machine and computer technology to take very clear, high-quality pictures of your colon from outside your body. The computer then combines these pictures to create a three-dimensional (3D) model of your colon. It's like taking a 'virtual tour' of your colon. This can help your doctor find even the smallest polyps without missing a beat.
This test does not require anesthesia. The entire test takes about 15 minutes. But there is one thing to keep in mind. If polyps are found during this test, you will need to have a traditional colonoscopy to remove them.
Doctors generally recommend that everyone be screened for colon cancer after the age of 45. However, if you have certain risk factors (for example, a family history of the disease), you may need to be screened earlier. You can talk to your doctor about which screening method is best for you.
How does this test work?
This is a very simple process.
1. First, a technician uses a CT scan machine to take many pictures of your abdomen and pelvis.
2. Then, computer software combines all these images to create two-dimensional (2D) and three-dimensional (3D) images of the colon.
3. Finally, a radiologist carefully analyzes these computer-generated images and checks for polyps or other abnormalities.
The most important thing is that no long instruments are inserted into the body during this procedure. That's why it's very safe and very uncomfortable.
How should you prepare before the test?
For a virtual colonoscopy to be successful, your colon needs to be completely cleaned out. We call this 'bowel preparation'. This involves removing all of the stool from your colon. This allows the doctor to see the inside of your colon clearly. This preparation is usually done the day before the test.
Your doctor will give you the necessary instructions for this. That advice may include the following.
| Preparatory steps | Description |
|---|---|
| Laxatives | These can come in liquid or pill form. Drinking these will make you need to go to the bathroom more often. This will completely cleanse the colon. |
| Clear liquid diet | You will not be able to eat solid foods the day before the test. Instead, you will be asked to drink only clear liquids such as water, unsweetened broth, apple juice, and unsweetened tea or coffee. Your doctor will give you a list of what you can and cannot eat. |
| Fasting | You will not be able to eat or drink anything for a few hours before the test. |
| Contrast medium | Sometimes, you are given a special liquid to drink so that the intestines can be seen more clearly on the scan images. |
| Enemas | In some cases, a medicine (suppository) inserted into the rectum may be recommended to cleanse the last part of the colon. |
This 'bowel prep' is essential for the success of the test. You will need to go to the bathroom frequently during this time, so it is wise to plan to stay home that day and be near a bathroom.
What happens during the test?
On the day of the test, wear comfortable clothing and no jewelry. At the hospital, you will be taken to the room where the CT scanner is located. This is a machine shaped like a large doughnut. Here are the steps involved in the test:
1. Preparation: After you put on the hospital gown, you will be asked to lie down on the exam table.
2. Insufflation: Next, the technician will insert a thin tube about two inches long through your rectum. This will slowly pump a little air into your colon. Don't worry, this is to make your colon swell a little so that the inside can be clearly seen on the scan images.
3. Scanning: The table you are on will then slowly move into the CT scanner. You may hear small clicking and buzzing sounds as the machine works.
4. Stay still: You must remain completely still while the scanner takes the images. The technician will speak to you through an intercom system. They may ask you to hold your breath for a few seconds, or to change your body position slightly.
5. Finishing: When you're done taking pictures, the table comes back out. Then you can remove the little tube and change your clothes.
This test should not be painful. However, you may feel a slight pressure in the rectum, a feeling of fullness, or a need to pass air because the intestines are filled with air. This is normal.
What are the advantages and risks of this method?
Like any medical test, this one has its benefits and some limitations/risks. Let's take a look at them.
| Benefits | Risks & Limitations |
|---|---|
| Quick: The entire test takes as little as 15 minutes. | Risk of bowel perforation: There is a very small, rare risk of bowel perforation due to air filling. |
| Clear images: You can obtain clear 2D and 3D images, just like you would with a traditional colonoscopy. | Exposure to radioactivity: There is exposure to very small amounts of radiation, but these doses are within safe levels. |
| No anesthesia required: Since there is no anesthesia, recovery is very quick. You can go home immediately after the test. | Skipping small polyps: Very small polyps (less than 6 mm) that are caught by traditional methods may be missed by this method. |
| Less discomfort: It is less invasive because a long tube (scope) is not inserted into the body. | Polyps cannot be removed: This is just a test. If a polyp is found, a separate traditional colonoscopy will be required to remove it. |
| Less risk of intestinal damage: The risk of intestinal damage is much lower than the traditional method. | Not suitable for everyone: This test may not be suitable for people with certain medical conditions. That's why the doctor will review your medical history. |
| Examination of other organs: This scan can sometimes accidentally detect problems not only with the intestines, but also with other organs in the abdomen, such as the liver and kidneys. |
What happens after the test?
After a virtual colonoscopy, you can resume your normal activities. You can also eat and drink normally. Since no anesthesia is used, there is no special recovery time required.
However, the air pumped into the intestines can cause some minor side effects.
- Bloating
- Feeling like stomach cramps
- Frequent passing of air (excess gas)
These are normal things. This condition will go away in a few hours.
What does the test report say?
The results of the test report can be in two ways.
1. Results are normal (Normal Results)
This means that no abnormalities or polyps were found in your colon. This is very good news. Your doctor will tell you when you should have your next test. If you are at low risk, you may be recommended to have this test repeated every five years.
2. Abnormal Results
If your test report says you have a polyp, it doesn't mean you have cancer. So don't worry. It just means that a small lump has been found that could become cancerous and needs to be removed.
To remove this polyp, you will need to have a traditional colonoscopy . In some hospitals, if possible, you will have already had your colon cleaned out, so you can have that done on the same day.
How accurate are these results?
Several studies have shown that virtual colonoscopy is as effective as traditional colonoscopy in detecting large polyps and cancer. However, this accuracy may vary slightly depending on the size of the polyp.
- It is very accurate in detecting polyps larger than 10 mm.
- Success may be slightly lower in detecting polyps smaller than 6 mm.
When to see a doctor immediately
If you experience any of the following symptoms after the test, even if they are very rare, seek medical advice immediately. Or go to the Emergency Department (ETU) of the nearest hospital.
- Severe stomach pain
- Blood in the stool or rectal bleeding
- Dizziness
- Fever
Colon cancer is one of the most common types of cancer among adults. But it can be easily treated if detected early. Many people avoid colonoscopy due to fear of the test. With fewer complications and a quicker recovery, virtual colonoscopy is a great alternative. Talk to your doctor to find out which method is best for you.
Take-Home Message
- Virtual Colonoscopy is a quick, less invasive screening method that can detect colon cancer early.
- This uses CT scan technology to obtain three-dimensional (3D) images of the intestine instead of a long tube.
- Proper bowel prep the day before the test is essential for the success of the test.
- If polyps are found during the test, a traditional colonoscopy will be performed to remove them.
- This is a great option for those who are afraid of or unable to have a traditional colonoscopy. Talk to your doctor about this and make a decision.
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