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A New Screening Test For Chronic Abdominal Pain

December 29, 2008
World Journal of Gastroenterology
Fifty patients with undiagnosed chronic abdominal pain of bowel origin underwent barium meal follow through (BMFT), BMFT with pneumocolon (BMFTP). Adding pneumocolon to BMFT not only helped in detecting ileo-cecal abnormalities better but also revealed other colonic abnormalities simultaneously obviating the need of colonoscopy and barium enema in a large subset of patients thereby lowering cost of screening these subjects which is quite important for developing poor nations where health budgets are quite low.

Evaluation of chronic abdominal pain of luminal etiology is a challenging problem for the primary care physicians and gastroenterologists. The exact localization of lesion to either small or large bowel remains an elusive identity in many subjects.

In tropical countries, where most of the population is of low socioeconomic status, one needs an imaging modality which screens small and large bowel lesions simultaneously at a reasonable cost with good sensitivity and specificity. Small bowel evaluation by BMFT and colonic evaluation by double contrast barium enema (DCBE) are the standard norms but doing them separately adds cost as well as discomfort to the patient. Pneumocolon has been combined with BMFT in previous studies for evaluation of ileocecal lesions but not as a screening modality for both small and large bowel simultaneously.

A research article to be published on November 21, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Nijhawan from SMS Medical College and Hospital, Jaipur, India tried to evaluate BMFTP as a screening tool for subjects with chronic abdominal pain of luminal origin where site of involvement (small or large bowel) is not well known based on clinical history.

This study revealed that adding pneumocolon to the BMFT can not only image ileo-cecal area better but also detect colonic lesions if present thereby obviating the need of doing Barium enema separately. Only subjects with strong suspicion of having recto-sigmoid lesions or having lesions depicted on BMFTP can then be taken for colonoscopy, thereby cutting down the overall cost to a large extent.

Based on the results of this study, the authors have proposed a step up approach of screening subjects with chronic abdominal pain of luminal origin. Following this approach, one would be able to pick up most of the subjects with underlying structural lesions and that too at a reasonable cost which is an important factor in developing nations where most of the people are of low socio-economic status.

Story Source:

The above post is reprinted from materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.

Journal Reference:

  1. Nijhawan S, Kumpawat S, Mallikarjun P, Bansal RP, Singla D, Ashdhir P, Mathur A, Rai RR. Barium meal follow through with pneumocolon: Screening test for chronic bowel pain. World J Gastroenterol, 2008; 14 (43): 6694-6698 [link]

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World Journal of Gastroenterology. "A New Screening Test For Chronic Abdominal Pain." ScienceDaily. ScienceDaily, 29 December 2008. <>.
World Journal of Gastroenterology. (2008, December 29). A New Screening Test For Chronic Abdominal Pain. ScienceDaily. Retrieved November 25, 2015 from
World Journal of Gastroenterology. "A New Screening Test For Chronic Abdominal Pain." ScienceDaily. (accessed November 25, 2015).

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