Besides endoscopy and colonoscopy, are there any other safer or less invasive procedures to check on polyps?

Doctor's Answers 2

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Dr Aaron Poh

Colorectal Surgeon, General Surgeon

A CT scan. But the problem is that it cuts both ways. Maybe I should introduce a little bit more about what we call a CT colonoscopy.

A CT colonoscopy is a special CT scan protocol, designed to look at the colon. By doing so, what this means is that you do need to get a full bowel preparation done. For those of us who were hoping that the CT colonoscopy avoids having to go through the horrible process of running to the toilet, unfortunately, that’s unavoidable.

And you’re absolutely right to say that a CT scan poses a much lower risk of perforation than a colonoscopy. But let’s bear in mind that a colonoscopy’s perforation rate is actually only about 0.1%. So we’re talking about an already very low percentage that you’re trying to bring down lower.

A CT colonoscopy has an accuracy that approaches that of conventional colonoscopy, but there is one very big limitation -- which is that you can see the lesion and what’s going on but unfortunately you’re not able to take it off and therefore you’re not able to look under the microscope, which is the gold standard to diagnose anything.

What your CT will show you is it says that you look like you have a polyp somewhere in the colon, in a particular region. But otherwise, that’s all it can comment. Does the polyp harbour any cancer in it? Is the polyp whichever subtype? We don’t know.

As a result of that, if you do have a positive CT colonoscopy, you’re going to end up needing a conventional colonoscopy to take out the polyp and let you know what’s going on.

Photo of Dr Aaron Poh
Dr Aaron Poh

Colorectal Surgeon, General Surgeon

A CT scan. But the problem is that it cuts both ways. Maybe I should introduce a little bit more about what we call a CT colonoscopy.

A CT colonoscopy is a special CT scan protocol, designed to look at the colon. By doing so, what this means is that you do need to get a full bowel preparation done. For those of us who were hoping that the CT colonoscopy avoids having to go through the horrible process of running to the toilet, unfortunately, that’s unavoidable.

And you’re absolutely right to say that a CT scan poses a much lower risk of perforation than a colonoscopy. But let’s bear in mind that a colonoscopy’s perforation rate is actually only about 0.1%. So we’re talking about an already very low percentage that you’re trying to bring down lower.

A CT colonoscopy has an accuracy that approaches that of conventional colonoscopy, but there is one very big limitation -- which is that you can see the lesion and what’s going on but unfortunately you’re not able to take it off and therefore you’re not able to look under the microscope, which is the gold standard to diagnose anything.

What your CT will show you is it says that you look like you have a polyp somewhere in the colon, in a particular region. But otherwise, that’s all it can comment. Does the polyp harbour any cancer in it? Is the polyp whichever subtype? We don’t know.

As a result of that, if you do have a positive CT colonoscopy, you’re going to end up needing a conventional colonoscopy to take out the polyp and let you know what’s going on.

Similar Questions

What are the most important screening tests for colon cancer in Singapore?

Hi Yvette, A colonoscopy is the most accurate screening test for colon cancer in Singapore. However, there are risks and costs involved with the procedure. As such, the stool tests offered (FOBT, FIT) are alternatives for patients who want a low-cost screening tool that determines their need for a colonoscopy. If a stool test is positive, one should undergo a colonoscopy as soon as possible. To understand more about getting a colonoscopy in Singapore, read The Complete Guide To Colonoscopies In Singapore (2018).

Photo of Dr Jason Lim

Answered By

Dr Jason Lim

Colorectal Surgeon

How are colonoscopies carried out in Singapore?

Hi Bing Qi, A colonoscopy often begins with the administration of a mild sedative which renders the patient unconscious or drowsy for the duration of the procedure. After which, the colonoscope is inserted into the anus, gas is pumped into the colon and the scope is advanced to the caecum. This is done by a series of maneuvers executed by the endoscopist’s right hand which twists, pulls and pushes the scope, while the left hand manipulates the up-down-left-right controls on the scope handle. This allows the scope to wriggle its way through the bends and corners of the colon.

Photo of Dr Jason Lim

Answered By

Dr Jason Lim

Colorectal Surgeon

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