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Milk May Be Pleasant Alternative for CT Scans

05 December, 2013

ISLAMABAD: Undergoing a scan of one's intestines isn't a pleasant experience for patients with conditions like Crohn's disease, especially since it means downing a concoction made with barium.

But a new study suggests there may be a more palatable alternative: milk.

Researchers found that milk coats the intestines well enough so that radiologists can properly view the organ in a CT scan.

The milk alternative "is interesting, and it's certainly cheap enough. Reading this, I might try it on regular patients," said Dr. Laurence Needleman, chief of CT at Thomas Jefferson University Hospital in Philadelphia.

Still, Needleman -- who's familiar with the study findings -- said milk may not be ideal for all patients, especially since it seems to produce images that are less precise.

Specific types of CT scans are often used to examine the intestines along with the liver and spleen, Needleman explained. Patients typically ingest one chemical and are injected with another; the two combine to create contrast and allow radiologists to better view the inside of the body.

In cases of Crohn's disease and other conditions, the purpose of these scans is to detect kinks or obstructions in the intestines, Needleman said.

Patients commonly drink a "contrast agent" called VoLumen, which includes barium. "I've tried it. It's one of the things I made sure I did," Needleman said. "It's not pleasant. It's not a positive experience to drink it. Drinking four glasses of milk probably will be easier."

In the new study, researchers compared VoLumen to milk in patients who were about to undergo CT scans of the abdominal/pelvic area.

Of those, 62 drank VoLumen, while 106 drank two doses of whole milk (one 400-600 milliliter glass, then a 200-400 milliliter glass -- a total of as much as one liter).

The study findings were to be presented Wednesday in Chicago at the annual meeting of the Radiological Society of North America.

The researchers found that VoLumen was better at allowing radiologists to view certain kinds of images. However, 42 percent of VoLumen patients reported abdominal side effects -- Needleman said it can cause diarrhea -- while only 25 percent of the milk patients did.

As to cost, VoLumen was $18 per patient compared to $1.39 for those who drank milk.

"We hope that substituting milk for other contrast agents will reduce the number of people who refuse imaging tests because they do not want to drink the oral contrast, especially children," Dr. Lisa Shah-Patel, a radiology resident at St. Luke's-Roosevelt Hospital in New York City, said in a statement. She is one of the study's authors.

But Dr. Raul N. Uppot, assistant radiologist at Harvard Medical School, is skeptical that milk will be a viable alternative. "I don't believe we should sacrifice image quality for improved tolerability," he said, adding that some patients may not be able to drink milk due to allergy, lack of ability to tolerate milk products, or existing bowel disease.

"This is only a small study, and when applied to the larger population of patients undergoing CT, I feel you will run into more complaints of discomfort and diarrhea (with milk)," he said.

In addition, Uppot said, "most patients at our institution tolerate the VoLumen with a few complaints of diarrhea."


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