Basil, I have had every test in the books. I would DEFINITELY go for the pill cam . . . it's easy to swallow and I had no problems with it at all, and it delivers a much more comprehensive look at your small intestine and colon.
The barium test and the CT scan tests are hard because you have to choke down all of that liquid (either Barium, which is like drinking cement, or the CT contrast, which is just nauseating).
Assuming you have somewhat normal motility, the pill camera endoscopy does give the best, most reliable info about what is going on in your small intestine. Its a difficult area to know just what is going on in there. If there is reason to suspect a stricture then there is, at added cost, the Agile Patency Capsule, same size as the PC but dissolvable w/in 3-4 days. If it passes the PC should pass as well. I can understand cost being a consideration and you might as well ask and know right up front what it is going to cost you out of pocket so you can make the best decision for you.
No mention of the CT Enterography? Its much more clear and accurate than the barium upper GI series w/SBFT. Of course, more radiation risk than w/the SBFT.
SBFT? Bottom of the barrel for Dx'ing purposes. BUT it has been the "gold standard" for small intestine involvement for years and years only recently being surpassed by the CTE and PCE. A good many of us were Dx'd via the SBFT.
I would concur that the PCE is MUCH LESS LIKELY to not irritate the colon. IF you opt to go w/the SBFT by all means DRINK LOTS OF WATER asap after the procedure and for the next 2-4 days until your BMs are natural color again. Start on MOM (Milk of Magnesia) regular dose the day of the SBFT. Bariuim sets up quickly in the intestines and does get HARD by the 3rd day or so. And I do mean HARD! Even the toilet has trouble flushing it down it is so heavy and hard. (Might be interesting to see how these new low flush toilets can handle a 3rd day barium stool *wicked grin*)
Post Edited (CrohnieToo) : 12/7/2008 9:00:29 PM (GMT-7)
Had a full blockage that sent me to the hospital...but resolved itself before they cut me open....
C-scan while in the ER showed the blockage.....
Doctor orders barium x-ray....I do that and while under going the procedure they also do some live action x-rays that showed the intestines as they moved about processing the barium.....now this test was done only 4 days after the blockage....results????? No major issues or narrowing of the small intestine could be seen. One area seemed questionable but diagnosis was not possible.
My doctor felt the x-ray was A) wrong B) inconclusive, so he suggested that I do the pill cam...he also felt that, given my last blockage added to the fact that I had experienced at least two more partial blocks in the week following, I might end up with the pill-cam getting stuck and thus require surgery to remove it.
The test was scheduled for Monday November 3rd.....I blocked on the 2nd, cleared that night, but went in for surgery on the 4th. They removed 2 1/2 foot of small intestine that the surgeon said was some of the worst (but not the worst) he had ever seen. There were two sections close to each other, one was about 18 inches long and the other was about 8 inches long with about 4 inches between them....so the entire piece was removed.
The pill cam would have most certainly showed this...but the x-ray did not...even when they knew where top look based on the c-scan taken during the blockage a few days prior.
Conclusion.....go with the best and most advanced tests available.