Colon Screening: Colonoscopy vs Virtual Colonoscopy & Ensure Success With Colonoscopy Prep

colonoscopy-questionIf you’re age 50 or older, you should get screened for colorectal cancer. But, which exam should you get?

When it comes to colorectal cancer screening exams, you’ve got choices.

Many people opt for a colonoscopy. But, virtual colonoscopy also is an approved option. And, to most people, it sounds much less invasive.

So, which should you choose? Let’s compare the two.

Colonoscopy: usually done every 10 years

When you get a colonoscopy, a doctor examines your rectum and colon with a lighted tube called a colonoscope. Your doctor inserts this tube into your rectum to look for unusual tissue changes and polyps.

Polyps are small growths on your colon wall. Left untreated, they can grow larger and become cancerous over time.


Polyp Removal — Your doctor can detect and immediately remove polyps during a colonoscopy. And, removing polyps can help you avoid colorectal cancer.

Little Discomfort – You doctor can give you medication to help you stay relaxed and comfortable during the exam.


Hard-to-Spot Polyps — Your doctor may not find every polyp during your exam. That’s especially true for polyps that are harder to spot, like small or flat polyps. But, a colonoscopy is still one of the most effective tests currently available.

Colon Cleansing — You have to cleanse your colon completely before the exam. This means you’ll take laxatives 24 hours before your colonoscopy. And, you won’t be able to eat or drink after midnight.

Complications — It’s not common, but inserting the colonoscope can cause bleeding and/or tearing of the colon.

Insurance Coverage – The co-pay for a colonoscopy is different for each insurance provider and can sometimes be costly.

Virtual colonoscopy: usually done every 5 years

When you get a virtual colonoscopy, your doctor does a CT scan of your abdomen and pelvis to create 3-D images that show polyps and other abnormalities inside your colon and rectum.


Less Invasive — Your doctor will insert a tube in your rectum and colon. But, it’ll be shorter than the tube used for a colonoscopy.

Fewer Complications — You won’t have to worry about colonoscopy complications, such as bleeding or tearing of the colon.

Spot More Than Polyps – Your doctor also can see things outside the colon. This makes it easier for your doctor to spot problems not just in the colon.


Hard-to-Spot Polyps — Like the colonoscopy, this exam may miss some polyps.

Colon Cleansing — You’ll still need to take laxatives 24 hours before your colonoscopy. And, you won’t be able to eat or drink after midnight.

Follow-up Colonoscopy — If your doctor finds a polyp or anything else unusual during your virtual colonoscopy, you’ll need to get a traditional colonoscopy to remove the polyp or perform a biopsy.

Radiation Exposure — Virtual colonoscopy exposes you to a low dose of radiation. You’ll be exposed to more radiation than a chest x-ray but far less than a conventional CT scan.

Insurance Coverage — Not all providers cover the costs of a virtual colonoscopy.

No test is perfect

Neither colonoscopy nor virtual colonoscopy is the perfect screening tool. In fact, no screening exam is 100% accurate. But, research shows that both exams are good options to check for and prevent colorectal cancer.

Start the colorectal screening discussion at your next check-up. Your doctor can help you decide which exam is best for you and share other colorectal screening options, like the fecal occult blood test (FOBT).

Remember, screening for colorectal cancer saves lives. Don’t put off this test for fear of discomfort. Either virtual or traditional colonoscopy can work for you if you follow your doctor’s recommended screening schedule and properly prepare for whichever exam you choose.

MAKE AN APPOINTMENT: Schedule an appointment for a colonoscopy, or other colon cancer exam, at MD Anderson’s Cancer Prevention Center. Call 713-563-5360 or request an appointment online.

Ensure Success with Colonoscopy Prep

If you really want to know what’s going on inside your colon, don’t show-up for a colonoscopy without a clean colon.

Many say that preparing for the colonoscopy is the worst part of the entire exam. But, it just so happens that it’s also the most important part.

“If the prep is done right, it’s easier for your doctor to see not only big polyps but also flat polyps, which can be harder to spot if your colon is not completely clean,” says Gottumukkala S. Raju, M.D., professor in the Department of Gastroenterology, Hepatology and Nutrition at MD Anderson.

Polyps are small growths on the lining of the colon that can become cancer.

“We really want to find those flat polyps because they tend to grow into cancer faster than any other polyp type,” Raju says.

Another great benefit to having a clean colon is that your doctor can spend more time carefully examining your colon instead of trying to wash away any stool that’s left.

“I remember patients who did not properly follow their doctor’s instructions and went in for their colonoscopy with a semi-clean colon,” Raju says.

“One of two things happened – the doctor couldn’t see the insides of the colon clearly, so the patient had to redo the prep and come in for a repeat colonoscopy. Or, even worse, the doctor missed a polyp during the exam—a hidden polyp with the potential to become cancer.”

man-drinking-waterSteps to a successful prep

Your goal should be to get your colon as clean as the palm of your hand before you go in for your colonoscopy. Here’s how to reach that goal.

On the day before your exam:

Eat plain cereal with milk for breakfast.

Eat a light lunch consisting of soups without vegetables.

Drink clear liquids only.

Don’t eat solid foods.

Drink a large volume of the special cleansing solution and/or special oral laxatives recommended by your doctor.

Split the solution dose.

Drink the first two liters on the evening before the exam.

Drink the second two liters four to six hours before the exam. This last step is critical to getting a really thorough clean.

“Preparing for a colonoscopy can be tough because you do get hungry,” says Marissa Mir, who recently had the exam. “It also can be uncomfortable because you have to stay near a restroom when you take laxatives and drink the solution.”

“But it’s so important to clean out your system because if any particle is left behind, it could cover up polyps,” Marissa says. “So, it’s very important to follow your doctor’s directions.”

Get a personalized prep plan from your doctor

Talk to your doctor about what you can and can’t eat before the exam. Ask your doctor about what’s the best way to clean your colon.

If you generally have problems with constipation, discuss this with your doctor. Your doctor may suggest drinking magnesium citrate so that you are not constipated on the day you begin taking the cleansing solution. Do not take Metamucil® and do not eat foods with small seeds, such as kiwi, cucumber or bread with sesame seeds. These foods can disrupt the cleansing process.

Remember to inform your doctor about any medications you’re taking, particularly aspirin products, non-steroidal anti-inflammatory medicines, arthritis medications, blood thinners, insulin or iron products.

Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Be sure to mention to your doctor any allergies you may have to medications.

If you have diabetes, ask your doctor if you need to adjust your insulin or other medicines to control blood sugar.

By: Adelina Espat, Courtesy of MD Anderson.

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