Double-contrast barum enema vs colonoscopy : the current practice at a local general hospital in Malta.

Abstract

Purpose DCBE and colonoscopy are the two main examinations used to examine the colon. A transition from conventional DCBE examinations to colonoscopy was expected to occur over the past decades yet this was not the case within a local general hospital. Colonoscopy carries a number of benefits, which outweigh the use of DCBE, yet patients are still referred for DCBE. The aims of this study were to analyse why DCBEs were still being carried out, rather than colonoscopy, and to determine the factors and decision making processes which were leading doctors to still refer patients for DCBE within a local general hospital. Method The data was collected by carrying out structured interviews with six referring doctors from a surgical department and six radiologists from a medical imaging department. The questions asked during the interviews were devised by the researcher after having carried out a thorough review of the literature. Results The results of the study indicated that colonoscopy would be the ideal procedure of choice for most patients presenting with clinical symptoms of a bowel condition, however this is not possible as there is a long waiting time for a colonoscopy. DCBE provides referring doctors with information on the patient's condition without having to wait so long for an examination. Referring doctors were not following any protocols when requesting examinations for patients and there was also not enough knowledge regarding diagnostic radiation doses to patients. The participants felt that DCBE still has an important role within the local setting and that this examination should not be lost. Conclusion Colonoscopy should be the primary investigation when examining the bowels. However, the long waiting time for colonoscopy does not make it possible for every patient to undergo the procedure. The researcher put forward recommendations based on the conclusions from the data collected. These were based on the present situation within a general hospital in which the study was conducted and not generalised to other hospitals.