Having a Large Bowel CT Scan (CT Colonogram)

Having a Large Bowel CT Scan (CT Colonogram) Department of Radiology Information for Patients i Radiology Leaflet No. 6

Contents Page number Introduction 3 Important information 3 What is a CT colonogram 4 How long will it take? 4 Who will be doing the examination? 4 Additional information for patients who have diabetes 5 How to prepare for this scan 6 What do I do on the day of the examination? 8 What happens during the examination? 8 Important information 9 What happens after the examination? 9 How do I get the results? 9 What kind of side-effects might I experience? 10 Support for people with learning difficulties 11 Other sources of information 11 Additional hospital information 12 Any questions? 15 2

Introduction This leaflet tells you about your examination. Please read it carefully as it contains important information and instructions. You, or a friend/relative will need to collect some medication to prepare for this test. Please telephone The Pharmacy at Glenfield Hospital on (0116) 235 5474 to organise how and where to collect the medication. Without this medication we cannot do the test. Please read your appointment letter carefully to check which hospital you must attend for your appointment. Important information Pregnancy: The scan involves the use of x-rays, if there is any possibility that you may be pregnant, please contact the Radiology Department immediately. For female patients aged 10 to 55 this examination must be carried out within 10 days of the start of your menstrual cycle unless there is no chance that you may be pregnant. If your appointment is outside this time please contact the Radiology Department on the telephone number on your appointment letter to reschedule your examination. You will be asked to confirm the first day of your last period before the examination starts. Please bring this information with you. Special requirements: If you require an interpreter, or if you have any special requirements please contact the Radiology Department for further information. 3

What is a CT colonogram? This is a scan used to examine the large bowel (colon), and is used as an alternative test to a colonoscopy (camera test). In some cases, you may need both a colonoscopy and the CT scan. How long will it take? You may be in the Radiology Department for up to 90 minutes. The CT scan takes between 10 and 30 minutes. The time will vary for each patient. Who will be doing the examination? A radiologist (a specialist x-ray doctor) or a specialist radiographer will carry out the examination. During the examination there will also be a radiology assistant present in the room to help with the examination. On occasions a student may also be present. If you wish, you can request that the student is not present during your examination. 4

Additional information for patients who have diabetes This leaflet includes specific information for people with diabetes who may be on insulin and / or tablets. Before your scan it may be necessary to alter your diabetes medication. Please follow the preparation instructions on pages 7 and 8 including those in grey. If you have diabetes it is advised you contact your normal diabetes care provider for information in managing your medication for this procedure If you have diabetes you should have received a morning appointment. If you have not, please contact the Radiology Department. It may be that we are not aware that you are diabetic. If you are taking diabetes medication you may be at an increased risk of having a hypo (Low blood glucose - symptoms include sweating, shakiness, blurred visions, light-headedness) when not eating for any length of time. To avoid this we recommend you follow the instructions in the table on pages 6 and 7, and please regularly check your blood glucose. Please make sure you have additional glucose drinks/glucose tablets at home. Examples of suitable glucose drinks include; Lucozade, fizzy drinks and clear fruit juices (but not diet or non-sugar versions). 5

How to prepare for this scan Make sure you have contacted The Pharmacy at Glenfield Hospital on (0116) 235 5474 to discuss how and when you will collect a special drink called Gastrografin which you need to prepare for your scan. You, or a friend/relative must collect this at least 24 hours before your appointment time. This drink paints the stools in your bowel, helping us to get a clearer scan. Taking these medications may make you open your bowels more frequently (diarrhoea) so you should ensure that you have easy access to a toilet on the day before the scan and on the morning of the scan before you come to hospital. This can be quite severe. Don t worry if you haven t been to the toilet frequently; the test can still be performed. You will also need to change your diet for the day before the scan, as well as to take the special drink at the times listed below. WARNINGS: Allergy to iodine If you have any allergy to iodine, do not drink the Gastrografin liquid. Please contact the radiology Department for advice and for any other questions on 0116 258 8765 and select option 3. Contaceptive pill If you take the oral contraceptive pill, sometimes it is less effective because of the diarrhoea caused by the medication so additional precautions are recommended for the rest of your cycle. 6

3 days before your scan 2 days before your scan The day before your scan 10am Stop any iron tablets you may be taking. Continue all other medication and any laxatives you normally take, until you come for your scan. Continue eating as normal. If you have diabetes - take all diabetic medication as normal. Do not eat any solid food today. You can have clear soups (e.g. strained chicken noodle soup, vegetable Bouillon), jelly, ice cream, custard, Complan drinks, Bovril and Oxo drinks, and water, clear juices, fizzy drinks, coffee and tea (with milk if preferred). Drink as much tea or water as you like, but take at least 1/4pint (150mls) of fluid every hour on the hour during the daytime. At 10.00 am: Drink half the bottle of Gastrografin (50mls) mix with an equal amount of water. You may add some fruit juice or cordial for flavour. 6pm At 6.00pm: Drink the second half of the bottle of Gastrografin (50mls) as above. If you have diabetes - You can continue drinking plenty of fluids and have glucose drinks as meal replacements. If you are on insulin, reduce your insulin dose by half. If you are on diabetic tablets DO NOT TAKE THEM. Check your blood glucose if you are able. 7

On the day of your scan Do not eat any solid food; You may drink water or clear sugary drinks. If you have diabetes - Morning of the appointment DO NOT take Insulin/Diabetic tablets Recheck blood glucose prior to arrival at hospital. You can continue drinking plenty of fluids right up to the procedure. Make sure you have glucose drinks with you. Bring your Insulin/Diabetic tablets and a snack/drink with you to the hospital to have after the procedure if needed. After the scan - Recheck your blood glucose. Take you diabetes medication after the scan and when eating. All patients- After the appointment Eat normally, but continue to drink plenty of fluids for the next couple of days. Take all medications as normal, unless advised otherwise during the scan appointment. 8

What do I do on the day of the examination? Please refer to the table above for information about your diet today. Please bring with you a list of your medications, allergies and medical problems. This will help us if we need to give you any medications during your scan. The radiographer doing your scan will ask you if you have any allergies, diabetes or any heart problems. What happens during the examination? On arrival at the Radiology Department you will be directed to the relevant waiting area and asked to change into a hospital gown. You will be taken into the scan room where the examination will be explained to you and you can ask any questions that you may have. You will be asked to lie down on the scan table. Before the scan you will be given a small injection into a vein in your arm. The injection is called Buscopan and it relaxes your bowel and prevents spasm so you should feel less discomfort. This improves the pictures that are taken. The injection may make your eyesight blurred but this should pass after about 30 minutes. A small tube will be inserted into your rectum (back passage), through which gas will be passed to inflate the large bowel so that all the surfaces of the bowel can be seen clearly during the scan. This will make you feel bloated as if you want to pass wind. It is very important that you hold onto the gas that is put inside. It may be necessary to perform the scan more than once with you lying in different positions. If you have difficulty turning, the staff will help you into the correct position. You may also have an injection of a contrast agent (a colourless liquid which shows up on x-rays and CT scans) through the needle already in your arm. This will show up the blood vessels. The supervising radiologist will decide this on the day and you will be fully informed. 9

Important information The contrast agent contains iodine and is excreted in your urine by the kidneys. Please tell the CT staff on arrival: If you are allergic to iodine, have any other allergies or suffer from asthma. If you have reacted previously to an intravenous contrast agent - the dye used for kidney X-rays and CT scanning. If you are on renal dialysis, have any problems with your kidneys or are seeing a kidney specialist. What happens after the examination? Once the scan is over, the needle in your arm will be removed and you will be taken to the toilet to get rid of the gas. After this you can go home. You may eat and drink normally afterwards. You may bring a snack to eat after the examination. This would be particularly useful if you are travelling to and from the hospital by ambulance. How do I get the results? The results will not be given to you immediately. Your CT scan pictures will be interpreted by a radiologist and the results will be sent to the consultant or GP who referred you for this examination. An explanation on how to get your results will be given to you after your examination. If you are an inpatient the results will be given to the doctors looking after you on the ward. 10

What kind of side-effects might I experience? Pain - After the examination a few patients get pain in their abdomen, like trapped wind, which soon passes. If you have any problems with this or have any discomfort please speak to a member of staff. Perforation - (puncture) of the bowel is rare and occurs in about 1 in 3000 cases, and when it happens, most cases resolve without any further treatment but you may need to be admitted for further care. Eye symptoms - if you were given an injection (of Buscopan) during the examination, the muscles of your eyes may have relaxed as well as the muscles of your bowel. This may cause a blurring of vision in some patients. If you are affected then we advise you do not drive until it returns to normal (this usually takes up to half an hour). If you have any pain in your eyes in the next 24 hours (this is very rare), please go to eye casualty at the Leicester Royal infirmary immediately. Tell the Doctor that you have had an injection of Buscopan and show them this leaflet. Dry mouth - the injection in your arm may cause you to have a dry mouth. This will not last long. Despite these risks, your doctor believes it is advisable that you have this scan, and do remember that there are also risks from missing a serious problem by not having the scan. Support for people with learning disabilities There is support available in our hospitals for patients with learning disabilities. Please contact the learning disability specialist nursing team on (0116) 258 4382 telling them when the appointment is and what examination has been booked. 11

Other sources of information Websites: For general information about radiology departments visit the Royal College of Radiologists website: ww.goingfora.com For information about the effects of X-rays read the NRPB publication: X-rays how safe are they, on the Health Protection Agency website: www.hpa.org.uk Please note that the views expressed in these websites, do not necessarily reflect the views of UHL or the NHS. University Hospitals of Leicester website: www.leicestershospitals.nhs.uk NHS Direct: For health advice or information you can call NHS on: 111. Additional hospital information How was it for you? If you wish to make any comments or suggestions regarding your visit to the Radiology Department please fill in a suggestion form or speak to a member of staff. Suggestion forms are located in all waiting areas within the department. University Hospitals of Leicester NHS Trust also has a Patient Information and Liaison Service (PILS), and you are welcome to contact them on: Freephone: 08081 788337 email: pils.complaints.compliments@uhl-tr.nhs.uk We review our information leaflets on a regular basis. If you have any comments about how we can improve these leaflets please speak to a member of staff. 12

Additional hospital information (continued) Directions and parking For information about getting to the hospital please see the hospitals website: www.leicestershospitals.nhs.uk/patients/getting-to-hospital Hospital car parking is available to all hospital patients and visitors. Spaces are limited so please allow plenty of time to find a car parking space. Parking charges are payable, please check tariff boards or the hospital website for full details. As well as the hourly rates there are a range of saver tickets available for patients and prime carers. Dedicated disabled parking bays are also available. Marked disabled bays exist outside of the public car parks for which there is no charge. If you park in the car parks the fee will apply. Drop off bays exist at the main entrances, these bays have a 20 minutes maximum stay. Certain qualifying benefits as notified by the Department of Social Security entitle the patient to free or reduced parking. For more information contact the Cashiers office. Bus services to the hospital Our aim is to ensure that there are car parking spaces available for those who really need to use them. We encourage you to use public transport or walk to the hospital if you are fit and well. For information on bus routes and times contact Traveline on 0871 200 2233. The hospital Hopper service runs from Monday to Friday, every 30 min from 06:30 hours until 18:00 hours and every hour from 18:00 hours until 21:00 hours. The Hopper stops at our three hospital sites, as well as other key locations such as Leicester train station, Beaumont Leys centre and Hamilton centre and also St Nicholas circle. www.leicestershospitals.nhs.uk/patients/getting-to-hospital/bustravel/hospital-hopper-bus/ 13

Additional hospital information (continued) Relatives and escorts You may wish to bring a friend or relative to accompany you to and from the Radiology Department when you have your examination although they may not always be allowed into the examination room. This may be useful if you do not understand English very well or if you have any special needs. Children Baby changing facilities are available. Please ask to be shown to them if you wish to use them. We are unable to offer childcare facilities. If you need to bring your children with you, please bring along an adult who can supervise them whilst your examination is being carried out. Radiology staff are not able to supervise your children. Facilities available: Refreshments: Refreshments including hot and cold drinks are available in the hospital. Please ask a member of staff for directions. Shops: Each hospital contains a shop selling magazines, newspapers, sweets and drinks. Please ask a member of staff for directions. This leaflet has been produced with reference to guidelines from the Royal College of Radiologists. 14

Any questions? If you have any questions write them down here to remind you what to ask when you speak to your consultant or nurse specialist. 15

Leaflet Produced: July 2016 Reviewed: April 2017 Review: April 2022 (Mear) - Radiology Edition 13 - IMA034-0417 Today s research is tomorrow s care We all benefit from research. Leicester s Hospitals is a research active Trust so you may find that research is happening when you visit the hospital or your clinic. If you are interested in finding out how you can become involved in a clinical trial or to find out more about taking part in research, please speak to your clinician or GP. If you would like this information in another language or format, please contact the service equality manager on 0116 250 2959