The Colon Club

My ob/gyn sent me for a cat scan because of an suspected aortic aneurysm. I didnt have that but the scan showed a pouch in my duodenum. So she is sending me for an upper GI. I have looked on here and think that I may have some symptoms of cancer or problems in my colon. I asked her today to schedule me for a colonolopsty (sp) and she said that if I had anything in my colon that the cat scan would have shown it. Would it? Or should I insist on lower testing? (I have a previous post on here describing my problems)

Well, it SHOULD show cancer, but if a growth is small enough, it would imagine it COULD miss it. Not sure how old you are, and if you have family history, but you'll see few people on here reccomending AGAINST colonoscopies. We're all fans

Speaking from my own experience, I had a tumor identified during a colonoscopy. My doctor ordered a CAT scan following the colonoscopy and nothing was visible on the scan. So, in my case the CAT scan showed nothing after the colonoscopy discovered the tumor. After surgery it turned out I had a 2 cm stage 2A tumor. If it were me I would insist on a colonoscopy because I believe in being thorough (to a fault). Good luck to you whatever you decide.

I have to agree with Skimonkey, I had a sigmoid tumor and many lymph nodes involved ( hence stage III) Ct scan showed "further follow up may be needed with this patient", MAYBE?

First of all a CT scan will only show a growth in your colon if it is big enough and it won't be able to tell you what that growth is - just that 'something' is there - more than likely, IF anything shows up it would only be a shadow. It also can't show, for example, diverticulitis, Crohn's or any number of other gastro symptoms. I went back and read your other posts and while it does sound like you have some problem, don't automatically assume that you have cancer. That's certainly not to say you shouldn't keep pressing for answers but there are a lot of other conditions that have many of the same symptoms you are describing. It sounds right now as though the upper GI is the right way to go as the CT scan identified 'something' there. You won't be knocked out for that particular test. If it is an upper GI as opposed to an endoscopy, you'll have to drink some barium and then the radiologist will watch how the barium goes through you. Usually, they don't watch it go all the way through, BUT....if they see something suspicious or something they want to watch more closely, you can be there for quite some time while the barium works its way through your digestive tract. Just be prepared. Since the CT scan did show something amiss in the duedomum area, they are going to focus on that first. It may very well be that truly that is the source of your problem but you won't know until you have further testing.

I would start keeping a journal (don't exaggerate or anything - just the facts) about all your symptoms. When do they start - for example, how long after eating. How long do they last??? How do your symptoms affect your bowels. Pay attention to what you are eating - write down the foods and be specific. Some of your gastric symptoms could be occuring if, for example, you had celiac disease. If the upper GI doesn't show any problems, going in with a detailed list of your symptoms, times, duration, etc. can be very helpful to the doctors and can help them make a determination about what tests to do next and what they can rule out and not waste time on. So be thorough, be concise, be meticulous and write down everything. Don't though, automatically jump to the conclusion that you have colorectal cancer.

Just remember that while a colonoscopy is a very good test for the large intestine, it is NOT going to discover what is going on in your duodenum and that IS the place right now where the CT identified that a "pouch" exists.

Jaynee

I had a CT before Dx and before a colonoscopy. The results? "Possible mild colitis with some reactive lymph nodes." The suggestion for follow-up was 3-6 months and NOT for that issue, but for what was seen on my ovary which is just a cyst that has been there for years. I insisted that we follow up because my pain problems were not getting better, just worse and worse.

I had a colonoscopy just over a week after my CT. The results? I was almost completely obstructed, so bad that the GI Dr called the surgeon and I was scheduled for pre-op appt the next morning and surgery the following day. The tumor had penetrated the colon wall and those "reactive lymph nodes" were malignant nodes.

So, "will a scan show if there is anything in the colon?" Yes, and no - and it is NOT a replacement for a colonoscopy.

Sorry, but it is too much trouble to go searching for a previous post that describes your sypmtoms, so I don't know what they are. If you have blood in your stool, thinning of your stools, mucas in your stool, pain when your bowels move - any or all of these together - I'd push for the colonoscopy.

A regular CT...probably not. But a CT Colonography (otherwise known as a Virtual Colonscopy)..quite likely. The latter is what you should be pushing for....if not for a regular old fashioned scope.

vganus,

It is time to switch doctors. Your Ob/gyn is now out of her area of expertise. Switch to a gastroentrologist or go to your primary care physician. You need to have the right doctor running down your gastro problem.

The short answer is yes, but it has to be a pretty darn big tumor. A small one can be easily missed.

Virtual colonoscopies might be the wave of the future, but they are not available in all areas.
And if a virtual colonoscopy shows a suspicious mass, then you have to go and get a real one.

I can see a place for virtual colonoscopies for screening purposes, but I am not sure where they fit in the realm of diagnostic colonoscopies ., which I believe is what the original poster needs, IMHO.

Peace

Actually, my last scan showed diverticulum. Made me wonder why they could see that and not tumors, it would be a lot easier than a scope. I also recommend you have a followup scope. Better safe than sorry!

First, I think you probably want a GI doc to be advising you at this point. If something is going on in you gut, it's the GI doc who will have the best understanding of the big picture. It's nothing against the OBGYN, it's just not her area of expertise. You wouldn't see a GI for gyno problems, so why see an OBGYN for GI problems? The OBGYN did her job to get you to this point, now it seems time for GI specialist.

Is it possible for something to not show up on CT? Yes. But most of the time I think the most likely cause of a problem is the cause of the problem. If there is a known "pocket" in the duodenum and it could be the cause of your symptoms, it seems reasonable to pursue this cause first. I don't think a colonoscopy will shed any light on what's going on in the duodenum. The upper GI should at least help rule some things out. Going straight to a colonoscopy seem like going straight to the edge cases.

But ultimately I'd let the GI advise you as to the most appropriate next steps.

My first CT was in the ER. IV contrast and rectal contrast, but nothing to drink. The scan showed tumors in the liver but nothing in the colon. I saw my primary doctor that morning, when I left the ER. He took the scan report and the blood work and sent me straight to the GI specialist. Five days later, the colonoscopy showed the primary tumor.

I don't know why the CT didn't show the colon tumor, but in my case the colonoscopy certainly made the difference.

After the colonoscopy revealed a cancer within the cecum near the ileocecal valve, I was sent for a CAT scan to see if there was cancer anywhere else. The CAT report stated thickened lumen in the large intestine and several enlarged lymph nodes; suspicious for cancer. However, the actual tumor which was 2.5 x 3.5 cm was not seen on the CAT scan and the CAT cannot tell if a lymph node is reactive or if it is enlarged due to cancer. CAT scans cannot reliably detect growths within the colon. Colonoscopy is the gold standard and only definitive tool to find abnormalities within the colon that could be cancer.

JAZZ

vganus wrote: I asked her today to schedule me for a colonolopsty (sp) and she said that if I had anything in my colon that the cat scan would have shown it. Would it?

No, NOT necessarily.

vganus wrote: Or should I insist on lower testing?

Yes, I would follow up with the GIT docs.

Cheers
CRguy

Yes and no.
What will find it is a barium enema...of course a colonoscopy...a nuclear scan that will find all activity that looks suspicious in your body if done right.

A GI doc is the way to go.

jA