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DrRussMD
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 64051
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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GI expert needed: CT scan or flex sigmoidoscopy/colonoscopy? Which

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GI expert needed:
CT scan or flex sigmoidoscopy/colonoscopy?
Which provides better/more information regarding the health of the tissue in the last 3 feet of bowel? (patient has an Ileal Rectal Anastimosis, and we want to look for Crohn's related issues, such as inflammation, strictures, etc. because patient is experiencing severe lower abdominal pain with some distension. Please compare the preference between these two diagnostic tests by rating each from 1-10.
Hello from JA
Colonosocpy.
It is the only useful test out of the 3.
The others are not really indicated.
For what you are looking at, you have to look at the whole colon.
The scan is not useful and you can not do a biopsy.
In many cases a biopsy is the only way to diagnose.
Colonoscopy 10.
Others zero.
Use reply to let me know if you have further questions.
Please to not forget a positive rating when done.
Customer: replied 3 years ago.

But to clarify, it's an IRA, so there is no colon.


The pain and swelling seems to be coming from the ileum, which is attached directly to the rectal stump; AND also has stitching a little further up, where until 4 months ago there was a loop-ileostomy. A Crohn's diagnosis has already been made. All previous scopes have shown disease limited to the colon and rectum; this new pain brings the concern the disease has spread to the small intestine... and/or there is a structural problem in the section that was previously used for the loop-ileostomy. With this clarified picture of the situation, would you change the usefulness scores of CT vs. Scope?

I see.
IN many cases, a CT might be done, but would only show inflammation, swelling, etc..it would not diagnosis crohn's.
So the answer is essentially the same.
A scope would be needed, mainly due to the need for biopsy.

Use reply to let me know if you have further questions.
Please to not forget a positive rating when done.
Customer: replied 3 years ago.

OK, so to wrap this up and make sure I understand fully, next to each item, specify which test (CT or scope) would be better suited to detect a:


stricture -


fistula -


problems with the intestinal stitching -


intestinal inflammation -

scope for all.

CT might show a stricture or fistula., but not better.
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