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To: puborectalis who wrote (39169)	10/23/2000 6:11:57 AM
From: DlphcOracl	Read Replies (1) \| Respond to of 57584

OT to Fallope I respectfully disagree. The barium enema will not detect polyps less than 10 mm as accurately as colonoscopy. This is because it is quite difficult to differentiate them from air bubbles introduced during an air-contrast barium enema (ACBE) or (occasionally) versus small amounts of residual fecal material, a common problem in the elderly regardless of what bowel prep one uses. The barium enema is indeed a complimentary procedure and can serve as an excellent way of monitoring the colon during the 5-year interval between colonoscopies. Also, in elderly patients with tortuous, redundant colons where the colonoscopist cannot examine the entire colon, the ACBE will often visualize the cecum and ascending colon when the colonoscopist is unable to. You are correct in stating that the key to the bowel prep is to stay on clear liquids for 48 hours prior to the procedure and requires a less rigorous bowel preparation. Finally, patient selection and ability of the patient to fully cooperate during an ACBE are also factors. The patient must have sufficient strength and mobility to be properly positioned during an ACBE, often a problem in the elderly or infirm; a colonoscopy requires no patient participation or cooperation. FWIW, I'm a radiologist and perform barium enemas frequently.