Ask An Expert: Diverticulitis and Colonoscopy

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Ask An Expert: Diverticulitis and Colonoscopy

Question:

I have read contradictory information about virtual colonoscopy for people with diverticulitis. Should people with a history of diverticulitis avoid this or is it recommended in certain types of diverticulitis? If so, what types?

Answer:

Virtual colonoscopy, or CT colonography, is an imaging test developed to detect colon cancers and polyps. Unlike a traditional colonoscopy, the virtual type does not require the patient to be sedated intravenously, but it does require the same bowel cleansing. Most experts prefer traditional colonoscopy, but new technical advances may eventually improve the ease and accuracy of virtual colonoscopy.

Diverticulitis is an inflammatory disease readily detected by ordinary CT scanning, particularly if a contrast dye is given orally, rectally or intravenously. This type of CT does not require preparation or sedation, and it is fast and accurate.

CT scans can also be used to guide the minimally invasive procedure that drains a diverticular abscess. Colonoscopy or sigmoidoscopy can be used to diagnose diverticulitis, but CT scanning is preferred in most cases.

Virtual colonoscopy does not offer advantages for diverticulitis; in fact, the spasms that often accompany inflammation make this type of exam difficult, and few patients with diverticulitis could tolerate the prep. Because virtual colonoscopy requires filling the colon under pressure, it could even increase the risk of perforation or other complications of diverticulitis.

Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of Harvard Men's Health Watch (www.health.harvard.edu) and the author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan. Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

Last updated:	June 22, 2007