DOUBLE-CONTRAST BARIUM ENEMA AND FLEXIBLE SIGMOIDOSCOPY FOR ROUTINE COLONIC INVESTIGATION

Over a 5-year period, all patients referred for barium enema examinati on had a double-contrast barium enema and flexible sigmoidoscopy perfo rmed on the same day. A total of 462 joint examinations were performed . Abnormalities were found in 193 patients by the use of barium enema, 164 patients by using sigmoidoscopy and 294 by the use of both method s of investigation. Sigmoidoscopy was superior to barium enema in the detection of polyps and inflammatory bowel disease but barium enema wa s more sensitive for diverticular disease. The presenting symptoms had no predictive value in distinguishing carcinoma, polyps and diverticu lar disease. Diverticular disease did not reduce the sensitivity of ba rium enema examination to polyps in the sigmoid colon. Fibreoptic sigm oidoscopy immediately before barium enema was well tolerated by patien ts. The investigations were complementary in the diagnosis of colonic polyps, inflammatory bowel disease and diverticular disease.