Question: Hello Doctor,

My doctor ordered a Colonoscopy for me, mostly just for routine
screening(although I do have some GI symptoms). I talked to someone from the GI dept at my hospital about the fact that in the past I had a severe allergic reaction to
anesthesia(eg. propofol). So he suggested, as an alternative, either a Barium Enema
or a Flexible Sigmoidoscopy. But I need some more information so I can weigh the benefits vs risk of each test.
Specifically..
- Barium Enema:
- do you know how much radiation is involved in this test compared
to an average ct scan? Is it much less? The reason I ask is I already
took 8 ct scans in my life, and I'm concerned about my total radiation
exposure.

- I read it also involves a contrast agent. Is this one of those agents
that can cause kidney damage? The reason I ask is because my kidney
function tests have been declining lately, and I don't want to risk harming
them.

- Flexible Sigmoidoscopy:
- are there any risks to this procedure? This one sounds safer to me so
far than the Barium Enema.

- since it only examines the lower 3rd of the colon, I'm wondering if
it would have any diagnostic value for the type of GI issues I'm
having: mostly right upper quadrant pain(especially after eating), loose stools/diarrhea,
acid reflux.

I really should expand on my symptom picture a little more, because it
will probably give you some valuable information to go on.
My most severe and chronic symptom, aside from RUQ pain, is what seems
to be an excess of histamines in my system(eg. skin often flushes, itches,
feels hot/inflamed, and frequently hives. Also some dermatitis. Most
of the skin reddening is triggered by contact(eg. I can simply rub my forehead
then a few minutes later there's a big red streak there)).
One condition that might explain this is Carcinoid Cancer.
Do you think I should be tested for it? Maybe have the Chromogranin A (CgA)
or the 5-Hydroxyindoleacetic Acid (5-HIAA) test? If you were my doctor,
would you advise this?

Sorry my question wandered a bit. I'm trying to give you the
full picture so I can have a detailed discussion on where to go from
here(and it's hard to find the time with my current doctor to do that).

Thank you very much,
XXXXXXX

Hello again, and thanks for your answers. I will
take the Sigmoidoscopy based on your comments.
Seems the best and safest one.

As for allergy testing, which specific tests do you
recommend?

Also, which test(s) for MEN1 syndrome would you recommend?

Thanks again,
XXXXXXX