Medical Imaging Department NHS Foundation Trust Patient Information Barium Enema - Picolax Every Matters 1
Your doctor would like you to attend for a barium enema. This leaflet will help to explain what a barium enema is and answer some of your questions. Please read the entire leaflet immediately as you may need to contact the Department with important information. What is a barium enema? A barium enema is a special X-ray examination of the large bowel (gut). Before taking the enclosed laxatives. What you need to tell the staff in x-ray about If you have any of the following please contact us as soon as possible. Diabetes Kidney impairment/failure Myeloma Severe acute inflammatory bowel disease Difficulty in swallowing or have a peg feeding tube If there is any chance that you could be pregnant Before taking the enclosed laxatives - information for women If you are using the contraceptive pill it may become ineffective whilst taking the laxative and we advise that you take extra precautions to prevent pregnancy at this time. For women of child bearing age, this examination must be performed within the first 10 days of your last menstrual period. If this appointment is outside this criteria please contact the Department as soon as possible. 2
Information about Picolax Please read the product information leaflet enclosed with the laxatives for a list of potential side effects. Picolax is a strong laxative and may cause you to become dehydrated; this is especially the case if you take water tablets. If you are diabetic we would like you to contact the Department as we may decide to give you an alternative laxative. Do you need to follow a special diet? To prepare you for this examination it is important that your bowel is completely empty. You must not eat any solid food on the day you take the laxatives and up to your appointment. You must take the enclosed laxatives. The product information leaflet states that you can eat food with picolax, however for this procedure we ask that you do not eat any solid food. What can you eat and drink? The day before you have the barium enema your diet should consist entirely of fluids, to prevent dehydration drink plenty of fluids, try to drink approx 4-5 pints (equivalent of 2-2.5 litres) during the day including: Tea Coffee Milk Mineral drinks Smooth fruit juice Squash Build-up Complan Oxo Bovril Clear soup You may also have plain yoghurt, ice cream and jelly, in moderation, for example: one bowl of yoghurt and/or one bowl of jelly and icecream. You may also suck boiled sweets and pastilles. A suggested meal plan for diabetics is available on the last page of this leaflet. 3
Medication If you take any form of medication, please continue to take it as normal, but we suggest that you leave a minimum of 1 hour between taking the medication and taking the laxative as you may not absorb the medication. If you are taking iron tablets please stop taking them 7 days before your appointment. If you are taking any regular laxatives, including bulk forming laxatives such as Fybogel and ispaghula husk. Please stop taking these at least 2 days before your appointment. When do you need to take the enclosed laxatives? These need to be taken the day before the examination. The first sachet of picolax should be taken at 8.00 am. Mix the contents of one sachet in a cup of cold tap water (approximately 150 mls). Stir for 2-3 minutes and drink the solution. If it becomes hot, wait until it cools sufficiently to drink. IMPORTANT: Please avoid plastic cups/containers. The second sachet should be taken at 4.00pm and mixed as before. THE POWDERS YOU ARE TAKING ARE A POWERFUL LAXATIVE, which will cause several bowel movements and can act quite quickly. You should stay within easy reach of a toilet. On the day of your appointment you may find that the laxative is still working, this is normal. On the day of your appointment continue to drink fluids from page 3. 4
Due to the laxatives you may suffer from dehydration. This may lead to headache, dizziness and mild confusion. It is therefore important that you drink fluids from the list on page 3 throughout the process. Allergic reactions Allergic reactions are extremely rare but as with all medications possible. A reaction could be a rash, itchy skin, redness and swelling, difficulty in breathing and wheezing. If you experience any of these symptoms seek medical help. In the case of extreme reactions attend Accident and Emergency Department and please bring any packaging. Please note that diarrhoea and anal (bottom) irritation is common and is not a sign of an allergic reaction. For other possible side effects please see the product information leaflet. What happens when you arrive in the Medical Imaging Department? Please bring this appointment letter and on arrival report to the first reception desk in the x-ray (medical imaging) Department. Once registered, they will advise you where to wait. You will be asked to change into a hospital gown, if you wish you can bring your own additional dressing gown, as we are no longer able to provide one. What does the examination involve? The examination will be carried out by either a radiology registrar or a radiographer specialised in barium enemas. You will be taken into the x-ray room and the procedure will be explained and you will have the opportunity to ask questions. 5
We will then ask you to lie on the table on you left side. A small tube will then be inserted into your bottom (rectum), this tube is specially designed to help you retain the barium throughout the examination. Barium and air will be introduced through this tube. During the examination you will be given a small injection into a vein either in the back of your hand or in your arm, this helps relax the muscles around the large bowel. The injection may cause you to experience blurred vision. The effects will last approx 45 minutes to 1 hour. We advise you not to drive while your vision is impaired. As the barium fills your bowel you may feel the need to move your bowels, or you may feel abdominal pressure, this is common and is tolerated by most people easily. You will then be asked to move into different positions so that the best images can be taken. At the end of the examination the air will be drained back through the tube and the tube removed. You will then be shown to a toilet to empty any fluid or air that remains in your bowel. Most patients are able to return to normal diet and activities immediately after the examination, although you may experience a bloating feeling for a couple of hours post procedure. You can eat and drink as normal. Your stools may appear white for a day or so as your body clears the barium from your system. How long will the examination take? The examination usually lasts between 30-40 minutes. During the procedure you may experience abdominal fullness but it should not be painful. 6
Results - what happens after? After the procedure your x-rays will be examined by a Consultant Radiologist, and a full written report will be available for your referring clinician or GP usually within 7 days. Inconvenient appointment? If you are unable to keep this appointment, please contact the Department as soon as possible on 01270 612273 as we may be able to offer the appointment to someone else. If you are late for this appointment it may result in it being rescheduled. If you have any concerns or question in relation to these instructions please do not hesitate to contact the Department on the above telephone number. Suggested meal plan Breakfast...you can have a drink. See page 3 Mid morning...glass of fruit juice Lunch...Clear soup i.e. Consomme Plain flavoured Yoghurt/Fromage Frais (no solid fruit) Mid afternoon...glass of milk and glass of fruit juice Evening meal...fruit juice, Clear soup, Jelly & ice cream Supper...Fruit juice This leaflet is available in audio, Braille, large print and other languages. To request a copy, please telephone 01270 273104. 7
Mid Cheshire Hospitals NHS Foundation Trust Medical Imaging Department Leighton Hospital Middlewich Road, Crewe, Cheshire, CW1 4QJ Direct Line: 01270 612273 www.mcht.nhs.uk NHS Choices: www.nhs.uk Printed on certified PEFC paper. Sourced from sustainable forests. IMPRESSIONS DESIGN & PRINT 01270 767661 June 2011. Review June 2012 Ref: DCS/MI//0110611