The Unprepared Colon

Nearly all of the work on CTC to date has revolved around the laxative-prepared colon. As the promise of this technique is being realized, it is possible that compliance with colorectal screening guidelines will not improve appreciably even if CTC becomes widely accepted and available. The single biggest obstacle to guideline compliance is the inconvenience and discomfort associated with laxative purgation. If the laxatives could be excluded from the preparation, this would most likely result in improved compliance. Preliminary work in this field is encouraging. The basis for a laxative-free examination is the ability to adequately tag the stool in the colon. Theoretically, if the attenuation of the stool is changed significantly from soft tissue, a computer could electron-

ically remove the tagged stool, leaving a dataset similar to the cathartic-cleansed colon. Ideally, this would be done without dietary modification or disruption of lifestyle. Callstrom and colleagues [27] demonstrated that stool can be adequately tagged without dietary modification using barium liquid in divided doses (administered at meals and at bedtime) over 48 hours. Other investigators have confirmed these findings with some modifications. Lefere [28] has worked on dietary restrictions using a low fiber diet combined with barium to create low volume well-tagged stool. In these cases, the colon can be examined without electronic cleansing. Zalis [29] has utilized iodinated contrast material to create uniform stool labeling and effective stool subtraction. Iannaccone [30] demonstrated that large doses of oral io-dinated contrast material without subtraction can result in polyp detection similar to the cleansed colon. One issue that needs to be better understood is the common association of diarrhea with iodinated contrast material and its effect on patient compliance for colorectal screening. Clearly, the feasibility of examining the non-cathartic prepared colon has been proven. Once the technical issues are agreed upon, a new wave of CTC will occur with the promise of a full structural examination without the burden of the laxative preparation.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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