To the Editor.
—It was a pleasure to read the concise, yet thorough, article in the Archives entitled "Gastrointestinal Tract Bleeding of Unknown Origin" by Spechler and Schimmel (1982;142:236-240). However, I believe their comments regarding the efficacy of the barium enema and the diagnosis of colon neoplasms warrant an update. Their data sources underrating the barium enema, in particular the air-contrast barium enema (ACBE), are hardly applicable to today's proper assessment in comparison with various diagnostic modalities. There are several reasons, which include the lack of properly controlled studies in the past, the ongoing development of better barium suspensions, the evolution of interpretative abilities of radiologists performing the ACBE, and, finally, the continued refinement of proper techniques in obtaining diagnostic studies.I would refer the authors or any physician who perpetuates the belief that the barium enema is inferior to endoscopy to several recent comparisons of the two techniques and the