Barium enema, D.C. area?

Time for colon cancer screening. Last time was colonoscopy, but I’d like to go old school and get the DCBE. Yes, less sensitive for smaller polyps, but fine for most, especially lower, and it was the standard before colonoscopy. Does anyone know of a doctor or clinic in the DMV area that might honor my request? Most imaging centers dropped it during Covid-19, but a few still offer - I just need to find a doctor willing to write the order.

What do you plan to tell your GI doctor and radiologist as to why you want this older, messier, likely less sensitive procedure?

Eric, MD

My thought on how to get a barium x-ray, would be to have a concern about just how large and deep my diverticulie are. Or maybe how thin and possibly subject to opening and getting infected.

I don’t think colonoscopies can determine that depth or thickness.

I am too chicken to bring it up myself with a doctor.

Plus, my wife would see right through it, as a way to get a lot of enemas. 🫣

He could just say that he's tried the colonoscopy and he isn't going to do it this time, so he was looking for alternates and found the barium enema listed, which images the whole colon and doesn't have a high false positive rate. Honest and no fluff.

Good idea, @CharlieO, but be careful. If you have lots of diverticuli, a barium enema can perforate them. After my own surgeries, I've done some reading, and that can be a concern, but so can the colonoscopy. If it was me, I'd make an appointment with a surgeon and discuss it. Medicare still pays for BE's, partly because there are certain areas of the colon that colonoscopies don't visualize, I guess. The specific procedure is largely left up to the physician, who may or may not want to do it that way. I had two colonoscopies to go with my surgeries, so both the surgeon up here in the AZ mountains and the one in Phoenix prefer them. The second colonoscopy was during my second surgery, so I didn't know it was happening, but both surgeons evidently preferred colonoscopy to anything else.

Hope you do OK, whatever you select.

Have to say that were I to go in and say "I won't do that, but I will do this, and this is an informed decision in that I know the limitations" and the doctor responded "no, I won't do that" without specific and detailed reasons I would become very suspicious of either the doctor or just how important the screenings really were if they would rather not do them then negotiate for something that is also accepted but, most importantly, is accepted by the patient. It would be different if the patient was demanding something that didn't work at all.

I would also not give in. I do not like being pushed around.

If they do detect polyps during a barium enema, then they will most likely order/recommend a follow up colonoscopy to remove them. Then you get to do the whole bowel prep thing again…..as well as another procedure. Which for some, is part of the fun. I’d recommend you discuss it with your doc - pros and cons. If you’re wanting the BE just to enjoy a large enema, rethink why you want to take that approach.

@Tweedle In Fairfax, Virginia there is the Princeton Longevity Center.

They offer the virtual colonoscopy. Not sure about the bowel prep,

but they fill the colon with barium and then use a CT to scan. https://princetonlongevitycenter.com/virtual_colonoscopy

I actually had an order for one right when Covid-19 cranked up, then an iron curtain fell, and I couldn’t get anywhere near a facility as all resources were put on Covid-19. The order expired.

I had told my doc I wanted to pursue an option to colonoscopy. She said what about sigmoidoscopy? I said what about lower GI? She said, “ah, barium enema….you know - they have to put in……”. She’s Chinese, so sort of a translation moment on many levels! She said yes, you can do that. She wrote the order - I should have scheduled that day, had no clue Covid-19 was going to change options.

So….I can broach it with her, again, but was hoping to find a new doc that would accommodate - hate to press my GP again. I like Moliere’s advice, and thanks to all for your comments. I’ll keep thinking……

I think I can front with wanting to use more basic technologies, like sigmoidoscopy to visualize lower/rectum where many/most polyps are, followed with BE to image the entire colon. Can also mention concerns for diverticula - had a couple 10 years ago, both parents had diverticulitis - would like to know extent, depth, etc.. Plus CT for diverticulitis is much more radiation than BE x-ray/fluoroscopy. I’m seeing a CRNP so maybe I can hit her with all this and she’ll cave.