VIRTUAL COLONOSCOPY (CT Colonography) INSTRUCTION PACKET

Transcription

1 VIRTUAL COLONOSCOPY (CT Colonography) INSTRUCTION PACKET GENERAL INSTRUCTIONS (page 2) 2 bottles Magnesium Citrate prep, 2 Bisacodyl tablets, 2 bottles Gastroview, 2 bottles of BREEZA and 1 box containing 3 bottles of Tagitol FLOW DIAGRAM DAY BEFORE AND DAY OF PROCEDURE YOUR PROCEDURE IS SCHEDULED ON: Patient Name: DATE: TIME: (Please arrive 1 hour before this time) LOCATION: 4 th FLOOR CAT SCAN STONY BROOK UNIVERSITY MEDICAL CENTER Call with any questions ask for Vincent Foley or Lou Caronia 1

2 GENERAL INSTRUCTIONS In order for you (the patient) to complete the virtual colonoscopy procedure, your colon must be cleansed of all fecal material. During the day before the procedure, you will need to take a laxative and will be required to restrict your diet. The combination of the diet and laxative is called the patient preparation phase ( The Prep ). During the virtual colonoscopy exam, you must be able to hold your breath for seconds and lie on your stomach or side. During the test, a small rectal tube is placed in the rectum and carbon dioxide is passed through the tube into your bowels. You may experience mild discomfort, but should not feel any pain. A CT scan is done in both the prone (on back) and supine (on front) positions. Depending on the reason for the study, you may receive an intravenous injection of an iodine based contrast material. You will be in the room for approximately 30 minutes. SEVEN DAYS BEFORE PROCEDURE: If you are taking Coumadin, any other type of blood thinner, or insulin, please ask your doctor for further instructions. If you are taking insulin, depending on what type of insulin you are taking, you may need to reduce your insulin dose the day before the procedure. Please ask your diabetes doctor for exact instructions. Preregister at the hospital by calling CAT scan at ***Obtain Tagitol, Gastroview and Breeza from the CAT scan Department at Stony Brook University Hospital and Medical Center. Call Mr. Caronia Lou at *** Obtain two (2) bottles of 10 oz (296 ml) Magnesium Citrate Saline Laxative & two (2) Dulcolax (bisacodyl) 5mg tablets at the pharmacy of your choice and read through these instructions thoroughly. TWO DAYS BEFORE PROCEDURE: Follow diet instructions and Day Two table (page 3) (and drink 1 st bottle of Tagitol) ONE DAY BEFORE THE PROCEDURE: You may have a clear liquid breakfast and black coffee or tea without milk. Do not eat ANY meat, fruit or juice with pulp. Stay on a CLEAR LIQUID DIET. For the rest of the day consume only clear liquids. Clear liquids are: sodas, water, clear chicken broth, Gatorade, Jello, tea or coffee without milk. Clear liquid diet instructions are on page 7. Take magnesium citrate and Dulcolax tablets as directed. Take the Tagitol and Gastroview as directed. It is very important to take all of your bowel preparation to obtain a clean colon and an adequate colonoscopy. If you have any problems, call us at DAY OF THE PROCEDURE: You may take in clear liquids only up until 6 AM the day of your procedure. Daily prescription medications: Please take your morning medications the day of your procedure with a sip of water, except any medications for diabetes. Do not take any diabetes medications (insulin or pills) on the morning of your procedure. Depending on what type of insulin you are taking, you may need to reduce your insulin dose the day before the procedure. Please ask your diabetes doctor for exact instructions. 2

3 Follow the instructions below for your bowel cleansing! Two Days before procedure: Time Diet Instructions Around Noon Low Fiber Diet (p. 6) Follow lunch diet, see page 6 5:00 PM Low Fiber Diet (p. 6) Light Dinner, see page 6 6:00 PM Low Fiber Diet (p. 6) Drink 1 st bottle of Tagitol 20ml After 6:00 PM Clear Liquid Diet (p. 7) Clear liquid diet One Day before Procedure: Time Diet: See page 7 Instructions 8:00 AM Clear Liquid Diet(see pg 7) Drink 2 nd bottle of Tagitol 20ml & Take 2 Dulcolax tablets 8 AM 12 PM Clear Liquid Diet Drink at least 8 ounces clear liquids every hour 12:00 PM Clear Liquid Diet Drink 3 nd bottle of Tagitol 20ml 1 PM - 4 PM Clear Liquid Diet Drink at least 8 ounces clear liquids every hour 4:00 PM Clear Liquid Diet Take the 1 st bottle of Magnesium Citrate Prep (Drink entire bottle) 5:00 PM Clear Liquid Diet Drink at least 8 ounces clear liquid 6:00 PM Clear Liquid Diet Take the 2 nd bottle of Magnesium Citrate Prep (Drink entire bottle) 6 PM - 9 PM Clear Liquid Diet Drink at least 8 ounces clear liquids every hour 9:00 PM Clear Liquid Diet Take 60 ml of Gastroview (see p. 5 for mixing instructions) 10:00 PM Clear Liquid Diet Drink at least 8 ounces clear liquid Day Of Procedure: Time Diet Instructions 12AM 6 AM Clear Liquid Diet As seen on page 7 After 6 AM Nothing by mouth If diabetic: take ½ usual dose of insulin. If you have blood pressure or any other medications you may take with small sips of water only! Come to hospital 1 hour before scheduled procedure time. Important: Drink plenty of clear liquids throughout the day. For further instructions, see pages 4 and 5. 3

4 PREP 1(details): Clear liquid diet with MgCitrate Prep, Tagitol (Barium) and Gastroview (Iodine) *** Speak to your physician before using this prep, if you have renal disease, kidney disease, hypertension, diabetes, congestive heart failure. If there are any other doubts, please discuss with your doctor. AT LEAST ONE WEEK BEFORE THE EXAMINATION: Please read all instructions carefully. If you are diabetic and take medication, contact your physician to determine if changes should be made to your medication regimen (insulin or pills). Obtain two (2) bottles of 10 oz (296 ml) Magnesium Citrate Saline Laxative & two (2) Dulcolax (bisacodyl) 5mg tablets at the pharmacy of your choice and read through these instructions thoroughly. Obtain Tagitol, Gastroview and Breeza from the CAT scan Department at Stony Brook University Hospital and Medical Center. Call Mr. Caronia Lou at TWO DAYS BEFORE THE EXAMINATION: Starting with lunch follow a low fiber diet, (see Low Fiber Diet sheet, page 6). At dinner, have a low fiber dinner and drink the first bottle of Tagitol (20ml) (see page 3). You should take your regular medications with water, unless otherwise instructed by your physician. ONE DAY (24 HOURS) BEFORE THE EXAMINATION: Do NOT eat any solid food throughout this day. 8 AM You may have a CLEAR liquid breakfast. See Clear Liquid Diet sheet (page 7) for allowed liquids. Take 2 Dulcolax tablets AND also drink a second bottle of Tagitol (20ml). Do not eat any solid food throughout the day. You should take your regular medications with water, unless otherwise instructed by your physician. 9 AM 12 Noon - Drink at least 8 fluid ounces of clear liquids every hour. See Clear liquid diet sheet for allowed liquids. 12 Noon Eat a clear liquid lunch and drink at least 8 fluid ounces of clear liquids. Also, drink a third bottle of Tagitol (20ml). Do not eat any solid food throughout the day. 1 PM - Drink at least 8 fluid ounces of clear liquids.see Clear Liquid Diet sheet for allowed liquids. 2 PM Drink at least 8 fluid ounces of clear liquids. See Clear liquid diet sheet for allowed liquids. 3 PM Drink at least 8 fluid ounces of clear liquids. See Clear liquid diet sheet for allowed liquids. CONTINUED ON NEXT PAGE 4

5 4-5 PM Take the 1 st bottle of Magnesium Citrate Prep (Drink entire bottle) 5 PM Have a clear liquid dinner and drink at least 8 fluid ounces of clear liquids. Clear liquids consist of water, tea, coffee (no dairy products), strained fruit juice, broth, Jello, and Popsicle. Do not eat any solid food throughout the day, drink as directed. 6-7 PM Take the 2 nd bottle of Magnesium Citrate Prep (Drink entire bottle) 7 PM drink at least 8 fluid ounces of clear liquids. See Clear Liquid Diet sheet for allowed liquids. 8 PM drink at least 8 fluid ounces of clear liquids. See Clear Liquid Diet sheet for allowed liquids PM Add 1 bottle (30 ml) of MD-Gastroview to 1 bottle of Breeza (or other clear liquid). Stir gently and drink PM Add 2 nd bottle (30 ml) of MD-Gastroview to 2 nd bottle of Breeza (or other clear liquid). Stir gently and drink. During the remainder of the evening, you may drink clear liquids if desired, but do not eat solid food until after the virtual colonoscopy is completed the following day. THE MORNING OF THE EXAMINATION: You should take your regular medications with water, unless otherwise instructed by your physician. If you have an afternoon procedure, you may have clear liquids until 10 am. Do not take any diabetes medications (insulin or pills) on the morning of your procedure, unless otherwise instructed by your physician. If you have any other question regarding your medications, please call your primary care physician. 5

6 LOW FIBER DIET TWO DAYS BEFORE THE EXAM Suggested menu two (2) days before the exam starting with lunch. See the allowed/please avoid list below before choosing your meals: LUNCH Soup Fish/white meat chicken White rice Bread/cracker Dessert/fruit DINNER Soup Fish white meat chicken White rice, pasta or potato Bread/cracker Dessert/fruit What you can have to eat will improve the performance of the bowel preparation and enhance the diagnostic accuracy of the procedure. ALLOWED PLEASE AVOID Dairy: Limit to 2 cups Yogurt with fruit skins or seeds; Use low fat products, milk, plain yogurt, Strongly flavored cheeses Meat: Plainly prepared; fish, poultry, eggs Added fats, gravies, fried sauces, heavy seasonings, peanut butter Potato/Substitute: White rice, spaghetti, noodles/macaroni, potato with no skin Bread/Cereal: White (refined) breads, saltine crackers, cooked rice Potato with skin, brown rice Whole grain (graham, bran, cornmeal) breads, corn crackers & cereals, popcorn Fruit/Fruit Juices: Clear fruit juices, canned fruit Raw fruits, raisins, dried fruits, (no seeds, skin, or membranes) prunes/prune juice, skins Beverages: Coffee (limited), fruit flavored drinks, tea, carbonated drinks Soup: Bouillon/broth, strained soups, soups made with allowed vegetables, and meats Dessert: Gelatin, fruit ice, popsicle Miscellaneous: Salt, pepper, jelly, sugar Honey, syrup All others All others Coconut, nuts, seeds, hard clear candies, fruits that are not allowed on this list Cloves, garlic, seed spices, chili sauce, barbecue sauce, Any strongly flavored spice or sauce, mustard, jam, marmalade 6

7 Clear Liquid Diet DAY BEFORE THE EXAM You may eat any of the following: 1. Clear soup (any broth without solid materials) 2. Strained fruit juices without any pulp 3. Flavored or unflavored gelatins (do not add any extra ingredients) 4. Black coffee (no milk, cream or other creamers ) 5. Plain tea (no milk, cream or other creamers ) 6. Soft drinks, soda (no milk or dairy products) Jan 11,