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Virtual colonoscopy

Colonoscopy - virtual; CT colonography; Computed tomographic colonography; Colography - virtual

Virtual colonoscopy (VC) is an imaging or x-ray test that looks for cancer, polyps, or other disease in the large intestine (colon). The medical name of this test is CT colonography.

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How the Test is Performed

VC is different from regular colonoscopy. Regular colonoscopy uses a long, lighted tool called a colonoscope that is inserted into the rectum and large intestine.

VC is done in the radiology department of a hospital or medical center. No sedatives are needed and no colonoscope is used.

The exam is done as follows:

A computer combines all the images to form three-dimensional pictures of the colon. The doctor can then view the images on a video monitor.

How to Prepare for the Test

Your bowels need to be completely empty and clean for the exam. A problem in your large intestine that needs to be treated may be missed if your intestines are not cleaned out.

Your health care provider will give you the steps for cleansing your bowel. This is called bowel preparation. Steps may include:

You need to drink plenty of clear liquids for 1 to 3 days before the test. Examples of clear liquids are:

You will likely be told to stop taking aspirin, ibuprofen, naproxen, or other blood-thinning medicines for several days before the test. Keep taking your other medicines unless your doctor tells you otherwise.

You will ask your provider if you need to stop taking iron pills or liquids a few days before the test, unless your provider tells you it is OK to continue. Iron can make your stool dark black. This makes it harder for the doctor to view inside your bowel.

CT and MRI scanners are very sensitive to metals. Do not wear jewelry the day of your exam. You will be asked to change out of your street clothes and wear a hospital gown for the procedure.

How the Test will Feel

The x-rays are painless. Pumping air into the colon may cause cramping or gas pains.

After the exam:

Why the Test is Performed

VC may be done for the following reasons:

Your doctor may want to do a regular colonoscopy instead of a VC. The reason is that VC does not allow the doctor to remove tissue samples or polyps.

Other times, a VC is done if your doctor was not able to move the flexible tube all the way through the colon during a regular colonoscopy.

Normal Results

Normal findings are images of a healthy intestinal tract.

What Abnormal Results Mean

Abnormal test results may mean any of the following:

Regular colonoscopy may be done (on a different day) after a VC if:

Risks

Risks of VC include:

Considerations

Differences between virtual and conventional colonoscopy include:

Related Information

Colon and rectal cancer
Colonoscopy
Colorectal polyps
Colon cancer screening

References

Cash BD, Rockey DC, Brill JV. AGA standards for gastroenterologists for performing and interpreting diagnostic computed tomography colonography: 2011 update. Gastroenterology. 2011;141(6):2240-2266. PMID: 22098711 www.ncbi.nlm.nih.gov/pubmed/22098711.

Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126.

Kim DH, Pickhardt PJ. Computed tomography colonography. In: Gore RM, Levine MS, eds. Textbook of Gastrointestinal Radiology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 53.

Lin JS, Piper MA, Perdue LA, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;315(23):2576-2594. PMID: 27305422 www.ncbi.nlm.nih.gov/pubmed/27305422.

Van Schaeybroeck S, Lawler M, Johnston B, et al. Colorectal cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 77.

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Review Date: 8/1/2017  

Reviewed By: Subodh K. Lal, MD, Gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Internal review and update 11/06/2018 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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