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Clean vs Semiclean Colons

Roscoe E. Miller, MD
Arch Intern Med. 1978;138(6):1023-1024. doi:10.1001/archinte.1978.03630310097037.
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To the Editor.—  In general, I agree with the thrust of William H. Crosby's article, "Alvarez' Complaint," which appeared in the October Archives (137:1447-1448, 1977). Certainly I decry the "decerebrate practice of medicine." We should have facts instead of folklore. I agree that consideration should be given to the individual patient, his sensitivity to cathartics, his bowel habits, and his ability to withstand the preparatory ordeal for endoscopy and barium enemas.I do not agree with the implied emphasis that the bowel may not need to be properly (thoroughly) prepared and cleaned for barium enema examinations. There are exceptions, such as an emergency for bowel obstruction. However, the radiologist needs as clean a colon as does the colonoscopist; and both need a meticulously clean colon for their investigations of polyps or cancer and early inflammatory disease.1,2 This avoids repeated examinations.As an oncologist, Crosby must surely be aware that,


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