Barium meal follow through with pneumocolon: screening test for chronic bowel pain.
OBJECTIVE
To study the sensitivity, specificity and cost effectiveness of barium meal follow through with pneumocolon (BMFTP) used as a screening modality for patients with chronic abdominal pain of luminal origin in developing countries.


METHODS
Fifty patients attending the Gastroenterology Unit, SMS Hospital, whose clinical evaluation revealed chronic abdominal pain of bowel origin were included in the study. After routine testing, BMFT, BMFTP, contrast enhanced computed tomography (CECT) of the abdomen, barium enema and colonoscopy were performed. The sensitivity, specificity and cost effectiveness of these imaging modalities in the detection of small and/or large bowel lesions were compared.


RESULTS
Out of fifty patients, structural pathology was found in ten. Nine out of these ten patients had small bowel involvement while seven had colonic involvement alone or in combination with small bowel involvement. The sensitivity of BMFTP was 100% compared to 88.89% with BMFT when detecting small bowel involvement (BMFTP detected one additional patient with ileocecal involvement). The sensitivity and specificity of BMFTP for the detection of colonic pathology were 85.71% and 95.35% (41/43), respectively. Screening a patient with chronic abdominal pain (bowel origin) using a combination of BMFT and barium enema cost significantly more than BMFTP while their sensitivity was almost comparable.


CONCLUSIONS
BMFTP should be included in the investigative workup of patients with chronic abdominal pain of luminal origin, where either multiple sites (small and large intestine) of involvement are suspected or the site is unclear on clinical grounds. BMFTP is an economical, quick and comfortable procedure which obviates the need for colonoscopy in the majority of patients.
Nijhawan
Sandeep
S
Department of Gastroenterology, SMS Medical College and Hospital, Jaipur (Rajasthan) 302001, India. dr_nijhawan@yahoo.com
Kumpawat
Saket
S
Mallikarjun
P
P
Bansal
R-P
RP
Singla
Dinesh
D
Ashdhir
Prachis
P
Mathur
Amit
A
Rai
Ramesh-Roop
RR
D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology; D000284:Administration, Oral; D000328:Adult; D000388:Air; D001466:Barium Sulfate / Q000008:administration & dosage*; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis*; D003113:Colonoscopy / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D004106:Dilatation / Q000379:methods*; D004733:Enema / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D019722:Sphygmomanometers
D001466:Barium Sulfate