Introduction to CT Colonography CT Department Diagnostics & Therapeutics

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1 Introduction to CT Colonography CT Department Diagnostics & Therapeutics This leaflet has been designed to give you important information about your condition / procedure, and to answer some common queries that you may have.

2 Introduction You have been referred to us by your consultant for an examination called CT Colonography. This is an alternative method for imaging the large bowel and the surrounding organs. The large bowel and abdomen is scanned by the CT scanner which scans the body in thin sections using X-ray radiation so that a 3D image can be seen. Before the scan You will be asked to attend the department the day before the scan at 8am. As with any other examination of the large bowel, the intestines must first be cleansed. You will be given a diet sheet to follow and the first drink of contrast (X-ray dye) and a box of Picolax (laxatives). Part of the preparation is to empty the bowel and this may cause you to go to the toilet frequently, therefore you may wish to take this into account with regards to your daily activities e.g. it may be advisable to book the day off work. You must take all of your usual medications as normal unless advised otherwise by your doctor. The day of the scan You will be asked to change into a hospital gown and remove all your clothing including your underwear. During the scan This scan requires an injection of contrast medium into a vein of your arm. To give this injection we will place a cannula into your arm. Contrast (X-ray Dye) is given to highlight your organs on the scan. We may also give you an injection of Buscopan. Buscopan is a smooth muscle relaxant that stops the bowel from moving for a short time to enable us to get clear images. It is recommended that you do not drive for 2 hours after being given Buscopan as it can temporarily cause blurred vision. Although a rare occurrence, if your eyes become red and / or painful within the 24 hours after your examination please seek medical attention at your nearest Accident & Emergency department. Take this form with you. The bowel must be slightly inflated with air in order to unfold it and make it visible on the scan. This is achieved by pumping air into the colon through a rectal tube until a sensation of fullness occurs. The tip of the rectal tube will be placed into your back passage. Approximate 2.5cm-5cm will be inserted. Some of the scans will be done with you lying on your front, and some with you lying on your back, so you will be asked to turn over during the procedure. After the scan You will be directed to a toilet adjacent to the room where you can change back into your own clothes and pass some of the air from your bowel. You will need to wait in the department for 10 minutes after your scan. The radiographer will remove the cannula from your arm and then you will be able to leave the department.

3 You can resume your normal diet. Please ensure that you drink plenty of fluids to prevent dehydration. Are you diabetic? If you are concerned that this diet may aggravate your diabetes then please contact your diabetic nurse or your GP before following the diet sheet. If you are taking Metformin then please inform the radiographer when you get to the department. Getting your results Your scan will be reported by a Radiologist and a written report will be sent to the doctor that referred you for your scan. Concerns and Queries If you have any concerns / queries about any of the services offered by the Trust, in the first instance, please speak to the person providing your care. For Diana, Princess of Wales Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01472) or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01724) or at the PALS office which situated on C Floor. Alternatively you can Scartho Road Grimsby Scunthorpe General Hospital Cliff Gardens Scunthorpe Goole & District Hospital Woodland Avenue Goole Date of issue: October, 2014 Review Period: June, 2017 Author: CT / MRI Radiographers IFP-672 v1.3 NLGFT 2014 Northern Lincolnshire and Goole NHS Foundation Trust Diana Princess of Wales Hospital

4 PREPARING FOR A CT VIRTUAL COLONOSCOPY EXAMINATION Please follow these instructions carefully; the success of the examination depends on the bowel being as clear as possible. When you attend the department on the day prior to your examination, you will be given Picolax and Gastrografin, which are the preparations required for your examination. It is important that you follow the enclosed diet sheet in order to prepare your bowel for the examination. You should be prepared for frequent loose bowel movements at any time after taking a dose of Picolax. When taking the second and third doses of Gastrografin you can add fruit cordial to improve the taste Blackcurrant Squash works well! Please ensure you drink plenty of clear fluids (at least a tumbler full every hour) until bowel movements have ceased. Fluids may then be taken as much as required to satisfy your thirst. Tea, coffee, (black or with a small dash of milk), water, clear soups and meat extracts may be taken at any time. INFORMATION FOR FEMALE PATIENTS To ensure that there is no possibility of early pregnancy the examination should be carried out within 28 days of the start of your last period. Please let us know if your appointment does not fit with this. If you are taking the oral contraceptive pill, its effectiveness may be reduced due to the diarrhoea caused by the Picolax. If you do not want to become pregnant you should take additional precautions until you have finished your current pack of pills.

5 THE DAY BEFORE YOUR SCAN On arrival at the CT department Immediately on your return home from the CT department Breakfast Lunch (12:00-13:00) You will be given 30mls of Gastrografin diluted with water to drink and then monitored for minutes. Dissolve the first sachet of Picolax in a jug with one cup full of warm water and stir for 2-3 minutes (N.B. the drink will fizz) when cooled drink the mixture. Please choose from selection of foods at the end of this information leaflet Please choose from selection of foods at the end of this information leaflet AFTER LUNCH: Take 30mls of Gastrografin diluted with cupful of water. 15:30-16:00 The contents of the second Picolax sachet should be prepared as earlier and taken. AFTER 16:00 NO MORE SOLID FOOD 17:00 Take 30mls of Gastrografin diluted with cupful of water. Supper (19:00-21:00) THE DAY OF THE EXAMINATION Morning appointments Afternoon appointments Please choose from selection of foods at the end of this information leaflet Continue to drink plenty of clear fluids. Breakfast can be taken (Please choose from selection of foods at the end of this information leaflet). NO BREAKFAST. Light lunch may be taken (Please choose from selection of foods at the end of this information leaflet).

6 FOOD CHOICES It is important that you follow this diet sheet in order to prepare your bowel for this examination. Breakfast: Choose 1 of the following: 2 slices of white bread / toast with butter / margarine and honey or clear jam (no seeds or rind) Lunch: 1 slice of white bread / toast and 1 boiled or 1 poached egg 120g fromage frais or natural / plain yoghurt (without seeds or fruit pieces) Choose ONE of the following: And ONE of the following: 75g grilled white fish 2 slices of white bread / toast 75g grilled chicken skin removed 2 egg sized potatoes without skins 2 eggs boiled, poached or scrambled 2 tablespoons white rice / white pasta Tofu 1 small white Pitta bread 100g cheese 1 white chapatti Complan meal replacement Supper: Clear soup or meat / veg extract drink such as Bovril / Marmite / Oxo Clear jelly, vanilla ice-cream or Ambrosia custard for dessert Salt, pepper, sugar, sweeteners, lemon juice or honey can be added to season as required. Please ensure you drink plenty of clear fluids, these should be taken as much as required to satisfy your thirst. Water, carbonated drinks, clear juices, squash, drinking chocolate, tea & coffee (with a small dash of milk if desired), clear soups and meat extracts may be taken at any time.

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