Barium Enema or Exercise Stress Test?

Due to my advanced middle age, I am going to a Western hospital here in Bangkok on Saturday, October 6, for a complete and thorough physical exam. I figure it’s about time. My last physical was only a minor one about maybe four or five years ago. As far as I know, I’m pretty healthy apart from a touch of arthritis in my right shoulder.

This will be a very thorough, all-day endeavor. They told me that as part of the package, I may choose between a barium enema and an exercise stress test. I don’t know which one I should go for. I’m not even sure what either one is for. Does anyone have any advice regarding which one I should choose? (I was told that if I opt for the barium enema, I need to stop by the hospital a few days before to pick up certain laxatives that I’ll need.)

Thanks in advance.

hmmm lets see: have a doctor stick something painful up my ass, or run on a treadmill.

decisions, decisions.

Well, what is the barium enema supposed to check for, and what is the stress-test supposed to check for? Which of those conditions are you more concerned with?

IANA doctor or even much of a patient, but as far as I know and common sense seems to indicate, a barium enema looks for things wrong in your digestive tract and a treadmill stress test measures cardiovascular stuff.

I don’t think I’ve ever heard of anybody having a choice. I myself would choose “none of the above” but if I HAD to pick one, I’d pick the treadmill. The fact that you have to go by the hospital to pick up laxatives should tell you everything you need to know, and I seem to remember that in addition to this, you can’t ingest anything other than clear liquids for a couple of days (24 hours?) beforehand.

Been through alot of medical tests and the barium enema isn’t a routine physical test. If you’re around 50, or older, they might do a colonoscopy as a routine preventative measure. The stress test might also be considered in that light. You do not want to volunteer for a barium enema unless you have some problem that indicates a need.
IANADr. but some things are common sense.

I’ve never heard of you getting to choose what you want in a physical. Aren’t they meant to test for what you actually need?

I don’t see the need for the exercise stress test unless you have multiple major risk factors for heart disease–high blood pressure, smoking, high cholesterol, diabetes, family history of early heart disease. As far as I am aware, no medical body recommends stress tests for screening in patients with no suspicion of heart disease. Of course, if you have known heart problems or symptoms suspicious for heart disease a stress test could be indicated, but in that case your physician would be recommending you get it, unstead of giving you the choice between that and a completely unrelated test.

Assuming you are older than 50 and haven’t had a colon cancer screening in the past 5 years, the case for having a barium enema would be better supported. Although it is not the most frequently used tests, it is one of the ACS-recommended methods for colon cancer screening.

Since this seems to be a poll about the lesser evil between barium enema and treadmill test, I’ll move it to In My Humble Opinion.

General Questions Moderator

As long as you’re given a choice, select the nurse with the white miniskirt and cute lil cap. :smiley:

I’m going to put my support for the Barium enema.

Radioactive poop is the shit!


Don’t you mean:

Radioactive poop is the shit!

I’d say enema, for polyps or other colon growths. I had the stress test but only because my arm hurt when I walked too far. But I too wonder why they give you a choice, unless they mean do one that day and the other on a different day.

Can’t you do both?

In my non-medical opinion, get the tests you need, and skip the tests you don’t need. OTOH, I’m a ten minute drive from my doctor, and from the nearest hospital. It sounds like you have a long way to go for this physical. Usual caveats: I’m not a doctor, I’m not your doctor, your mileage may vary, void where prohibited, etc.

FYI, here’s an earlier thread on [thread=429109]Stress testing[/thread] (mostly the isotope variety).

From the perspective of an American (considering that American lifestyle is no doubt different than that in Thailand and the health risks thus might be different), I would opt for the stress test. It’s meant to help indicate if you have any severely narrowed arteries in your heart, something that the average middle aged American is very much at risk for thanks to our lovely dietary habits.

I’d expect that the barium enema is to check for colon cancer. Colon cancer is one of the most common and deadly cancers in western society, so it is definitely valid to be concerned about it, but the gold standard test for colon cancer is a colonoscopy, not an enema, so if you’re over 50 then I would look into if you can get a colonoscopy instead.

Well, this is Thailand, so they ALL look like that. :smiley: (That’s really not a joke either. They even wear high heels here. The ease on the eye of the typical Thai nurse is a big incentive to visit your doctor. :smiley: )

Thanks all for the answers. I’m not up on healthcare in the US these days, but I can tell it’s different there from here. The hospital I’m going to – BNH Hospital, which I’ve used before – is one of the best facilities in all of Southeast Asia, let alone Thailand. Very Western-oriented, and the doctors are all Western-trained. (The doc who treated my arthritis went to Harvard Medical School. Charges the outrageous-for-Thailand fee of US$23 for an office visit.)

The physical I’m going to take is part of a package. They have different packages available, and I thought I would do one of the more thorough ones. It’s called the Platinum Programme. You can see what’s involved. Yes, I could do both, but that would cost extra. (If you look at the link, you may see some items that are listed again below as extra; they put the same extras list with each package, and it just means that this will be extra if not already included.) The cost of this is 14,900 baht, which at the current exchange rate of 34 1/2 baht to the US dollar is about $432. Quite a lot to pay for a health checkup in Thailand, but again I feel it’s time.

In my e-mail inquiry to the hospital, I received this reply (excuse the odd English):

“Males can opt to choose between EST (exercise stress test) or Barium Enema. For Barium enema, you are required to come to BNH X-ray Department 2-3 days before the appointment date to pick up the laxative medicines. As for the EST, it is likewise a first come, first serve on the day of appointment. Kindly fast for 12 hrs prior to the check up.”

I think I’m leaning toward the barium enema. I’m at an age where I should be wary of colon cancer. They do, however, do one of those other tests that’s supposed to screen for colon cancer, but I have no family history of heart disease, have never had high blood pressure and am in reasonably good physical condition overall, so maybe the exercise stress test is not necessary.

Once again, thanks all. :slight_smile:

Actually, no, I’m in Bangkok, and BNH Hospital is rather close by, also about 10 or 15 minutes by taxi, even in Bangkok traffic. :slight_smile:

As a physician who used to monitor and interpret stress tests, and who still orders both stress tests and barium enemas, I would advocate for patients demanding the best of both worlds by having the barium enema, then seeing how far one can go on the treadmill before one can no longer hold one’s sphincter shut. Bets could be placed. :rolleyes:

I find it very bizarre that these tests, both useful for people with certain findings or risk factors but also have some inherent risks to them, are being offered like some sort of bonus for having signed up with a certain plan.

If one has certain risk factors for, or symptoms possibly due to, colon disease, then the BE may be a good idea.

If one has certain risk factors for, or symptoms possibly due to coronary artery disease, then the stress test is a good idea.

One should consult their physician to see if such a test is indicated. And if it isn’t, skip it.

Thailand is all about bizarre. That’s why it’s never boring living here, and I mean never.

So I consulted the hospital today (Sunday) and have decided on the barium enema. No family history of heart disease and never had high blood pressure, and they’ll be doing an EKG anyway. I HAVE had hemorrhoids before, though, and generally have somewhat loose stools (commn over here).

If this sort of medical package seems odd to some, I guess I’m just so used to it that I find it odd that it’s not offered in the US. All part of what’s called “medical tourism,” which has become a BIG industry in Thailand and India among other places. It really attracts a lot of Arabs and others from that region who no longer feel comfortable travelling to the US for healthcare; a couple of Thai hospitals have even set up branch hospitals in Persian Gulf countries to handle the overflow and make it even more convenient for patients. (Of course, coming to Bangkok for treatment also allows them to enjoy shopping and, most importantly for many of them, indulge in the many Muslim-oriented bars along and near our Little Arabia section of Sukhumvit Soi 3, but that’s a whole other story.)

To get an idea of what it’s like, here are the packages that BNH Hospital offers here. This is fairly typical of a Western-style hospital in Bangkok. For the physical I’m taking, I was pleased to hear they’re dropping the price 2000 baht for the month of October, so I’m ordering an extra ultrasound test, which will bring it up to about what I expected to pay anyway. (I had my choice of an ultrasound to check my prostrate or one to check my liver, gall bladder and one other organ I can’t remember; now I’m doing both.)

Siam Sam

How does BNH compare with Bamrungradt? (sp) My wife and I had some work done in Bamrungradt a few years ago and they were great. Also, the prices were amazingly low compared to what I expected to pay.

I agree about the nurses. You might be sick but if you have a few nurses around you definitely aren’t depressed. :stuck_out_tongue: