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3 replies

Need for CT plus Flex Sig.?

SavannahSavannahMember
Hi all,
I recently had a partial bowel obstruction/constipation(?) now resolved. It cleared on a liquid diet without hospitalization. It was scary for me as it was my one and only experience of this kind and it was difficult for my GP as she has admitted that I am her only j pouch patient. She now wants me to get a CT scan. However, I already have a routine flex sigmoidoscopy scheduled with my surgeon. I feel quite well. I believe my GP wanted me to get the CT before fully appreciating I had the scope scheduled a few weeks out and when I said as much she responded hastily "well the CT will reveal any obstruction and you wouldn't want a scope going into you if that is the case." But the thing is, I know the blockage is gone- I can tell! I fully appreciate the need for the routine flexible sigmoidoscopy but two exams seems like over kill to me. I really don't want the CT. as it seems unnecessary but I would go through with it if there really is a need. Thoughts appreciated.
Thank you so much,
Savannah
2005 Dx UC
2009 total colectomy/ileostomy
2010 two surgery reversal/j pouch
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L liz11Member
Even with a partial blockage most people don't get CT scans. Most partial blockages are resolved at home.. liquid diet, moving around a lot, etc.. Its only a full blockage that generally requires more serious intervention and possible imaging.

Even without that consideration what would the purpose of the CT be at this point in time? You had a partial blockage. It's resolved. Why be exposed to that amount of radiation if not needed.
SpookySpookyMember
I would go by how you are feeling. I suspect your GP is looking for a structural reason for your blockage, such as a narrowing of the bowel, adhesion or even a twist (though that is less likely since your symptoms have resolved). If it's higher up a sigmoid may not necessarily detect this, though I'm not sure it's necessarily "dangerous" to have a sigmoid under the circumstances.

CTs, IMO, are a lot of unnecessary radiation unless you are continuing to have symptoms. Of course, you could always call your GI's office and ask. Alternatively, they could do an MRI which does not have any radiation risk and in most cases will get a better picture anyway.
Jan DollarJan DollarModerator, RN, retired
Here is what I would do:

I'd tell them that you'd like to postpone the CT, unless your symptoms return. Have the sigmo, and at that time discuss with the surgeon if the CT is warranted. I agree that the CT adds to your cummulative radiation exposure, and it is an acceptable risk, when medically necessary. It should be based on your symptoms, not curiosity of your providers (or a desire to avoid future litigation).

In my mind, the time to scan was when you were obstructed, not when you are fine, as there will be nothing to see. If there is a stricture within reach of the scope, that will be evident.

Jan Smiler

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