Chris Kresser: I looked into this a while back. I’m not, off the top of my head, remembering what my conclusions were. I definitely think there are some better choices, but off the top of my head, I can’t make a specific recommendation.
One thing that I would like to point out, though,—and I mentioned this on a more recent Q&A—is that there is another test called magnetic resonance enterography, or MRE, which is basically an MRI of the abdomen and the pelvis. That test is pretty sensitive and specific for inflammatory bowel disease, and some have argued that it’s a better option, even, than a colonoscopy. In fact, the gastroenterologist that I often refer people to here in the Bay Area is a big fan of the MRE and likes it as a test … not necessarily more than colonoscopy, but if the patient is sensitive to the bowel washout or is concerned about that, then the MRE can be a good alternative.
Just a follow-up on the colonoscopy and MRE thing: The preparation for MR enterography appears to be different. Dr. Nett mentioned that in some cases patients have to do a washout prep for MR enterography, although I know in other cases that some doctors don’t require that, so there seems to be some difference there. And then one downside Dr. Nett mentioned of the MR enterography is that if a polyp is seen in patients, they’ll still have to have a colonoscopy for the biopsy, and then they would have to repeat the washout if they had to do a washout in the first place.
So MRE can be a good option if the patient is at low risk and doesn’t have a history or family history of polyps. There’s definitely a place for colonoscopy, and I will get back to you on the various preps. I have some research on that in one of my mini-files somewhere, so it’s just a question of finding it.