CT Colonography (Virtual Colonoscopy) with Gastrografin Preparation
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1 CT Colonography (Virtual Colonoscopy) with Gastrografin Preparation Information for patients X-Ray Department Phone no: Leaflet Ref: Published: 10/16 Review:09/19 Page 1
2 Patient Information CT colonography is a way of looking inside your bowel and abdomen. This information explains how it is done, what to expect and the risks involved. What is CT colonography? CT scans reveal more details of internal organs, bones, soft tissue and blood vessels than regular exams. CT colonography uses CT scanning to obtain views of the inside of the colon (large intestine). CT colonography is sometimes called virtual colonoscopy. How should I prepare? When you saw the Doctor at clinic you will have been given 2 bottles of Gastrografin. If you have not got your Gastrografin contact the x-ray department immediately. It is very important to clean out your colon the day before your CT colonography examination so that the radiologist can clearly see the lining of the bowel. Gastrografin is a laxative which will help to clear your bowel of stool(faeces). You will have been given two bottles of Gastrografin each containing 25mls. One bottle (25ml) is one dose. Leaflet Ref: Published: 10/16 Review:09/19 Page 2
3 Before taking your Gastrografin if you have any of the following: o Any severe allergies, particularly to x-ray contrast(dye) o Iodine o Severe asthma o Cardio-vascular problems o Take beta-blockers o Pregnant or Breast Feeding Please phone us on before you take the Gastrografin. How Do I take my Gastrografin? Do not dilute the Gastrografin. The first dose of Gastrografin should be taken at 8am, before breakfast, on the day before your CT examination.the second dose should be taken at 4pm on the day before your CT examination. During the day, whilst you are taking the Gastrografin you should follow a low-residue diet. Examples of food that you can eat are given on your appointment letter. To avoid becoming dehydrated while taking Gastrografin it is very important to drink plenty of fluids. This can be water or diluted cordials, herbal tea or black tea or coffee. It is recommended that you take approximately 2.5 litres of fluid during between 8am and 9pm. After 9pm you should have no further food until after the CT appointment. The Gastrografin may cause frequent, loose bowel movements at any time after taking a dose. Gastrografin may also cause abdominal cramping, nausea, vomiting, skin rashes, itching, heartburn, dizziness or headache in some patients. Most reactions are mild and pass quickly. Leaflet Ref: Published: 10/16 Review:09/19 Page 3
4 How is the procedure performed? On arrival at the CT department you will be shown to a changing cubicle and asked to undress completely and put on a hospital gown. It is advisable to bring a dressing gown with you to put on over the gown. A member of the CT team will then take you to our preparation area: to explain the test and answer any questions before asking for your consent. discuss the CT safety questionnaire with you Insert a small tube (cannula) into a vein in your arm which will enable us to inject some x-ray dye (contrast) during the examination. You will then be taken into the CT examination room and asked to lie on your left side on the CT examination table. The Radiographer will pass a small, flexible tube approximately 5 cm into your back passage (rectum). A small retention balloon on the end of the tube may be inflated inside your rectum to help keep the tube correctly positioned. A muscle relaxant (Buscopan) will normally be injected through the cannula in your arm. This helps prevent spasm in the bowel. Gas (carbon dioxide) is then gently introduced into your bowel through the tube in your back passage. This is done at a controlled rate by a machine specifically designed for the purpose. Despite the muscle relaxant you may still feel some bloating and discomfort in your abdomen like bad wind. Once the radiographer is satisfied with the amount of gas in your bowel CT scans will be taken with you lying in 2 positions: o On your front o On your back. During this scan the radiographer will inject some x-ray dye through the cannula in your arm. Each scan will take approximately 10 seconds. The whole procedure takes approximately 15 minutes. Leaflet Ref: Published: 10/16 Review:09/19 Page 4
5 Are there any risks? CT colonography is generally regarded as a very safe test. Problems can occur but they are very rare. Problems which may occur are similar to those which can happen with other methods of examining the large bowel. These include Abdominal discomfort Feeling faint Damage to the bowel wall (there may be a small tear in the lining of the colon or rectum: this happens in fewer than one in 3000 tests.) Dehydration or an electrolyte imbalance caused by the laxative. It is important that you drink plenty of fluids. If you feel unwell after taking your laxative, please do not take any more and phone us on or contact your doctor. Like any x-ray examination, this test uses radiation. We will keep the radiation dose as low as we possibly can, while still making sure that your scan is of adequate quality. What are the risks of having an x-ray contrast (dye)? It is very rare but a small number of patients may have an allergic reaction to the contrast. Most allergic reactions occur within the first hour after the injection so it is for this reason that you will be asked to remain within the hospital for this period of time. There is a very small risk that contrast can cause renal failure. To minimise this risk we check renal function on all patients who are having an x-ray contrast injection. There is evidence that keeping yourself well hydrated before and after the injection also minimises this risk, for this reason you will be asked to drink water before the scan and advise a further 1 litre of fluids over 24 hours after the scan Leaflet Ref: Published: 10/16 Review:09/19 Page 5
6 There is a very small risk that the contrast will leak into the tissue around the vein during the injection. This is called extravasation. We will do our best to prevent this problem from happening. Where possible a member of staff will stay with you during the injection so that if extravasation does occur the injection can be stopped immediately. The injection will be performed by a specially trained Radiographer who will be happy to answer any questions that you may have. What happens after the test? As soon as the scans have been taken the tube will be removed from your rectum. Your abdomen will immediately feel more comfortable. You will be escorted back into the waiting area where you will be observed for 15 minutes by the CT team. You may use the toilet, though most of the gas will be absorbed through the bowel wall. If you feel unwell in any way you must tell a member of the team. If you are feeling well after this period the cannula will be removed from your arm and you will be able to get dressed. You can now leave the department, though we do advise that you stay within the hospital for a further 45 minutes. You can eat and drink normally. Your Consultant or GP will have the result of your test within 7-14 days. Leaflet Ref: Published: 10/16 Review:09/19 Page 6
7 Comments, compliments or complaints We welcome any suggestions you have about the quality of our care and our services. Contact us: Freephone: Phone: Textphone: Customer Care, Reception, Macclesfield District General Hospital, Victoria Road, SK10 3BL For large print, audio, Braille version or translation, contact Communications and Engagement on East Cheshire NHS Trust operates a smoke-free policy (including e-cigarettes) For advice on stopping smoking please contact the KICKSTART Stop Smoking service on East Cheshire NHS Trust does not tolerate any form of discrimination, harassment, bullying or abuse and is committed to ensuring that patients, staff and the public are treated fairly, with dignity and respect. We welcome user reviews of our leaflets. Please share your comments, reviews and feedback with us by sending to ecn-tr.patientinformation@nhs.net. For further information on the references and sources used for this leaflet, please contact Leaflet Ref: Published: 10/16 Review:09/19 Page 7
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