Patient Instructions for CT Colonography

Before the Test

• Bowel preparation - please see below CT Colonography Diet Sheet*.
• If you are taking Metformin (Glucophage) tablets for diabetes, please inform your physician and/or technologist. He/she may request that you stop taking these tablets for two days after the test.
• If you are taking any other medications, you should continue taking all your other medications except Iron tablets which should be stopped seven days before your CT Colonography.
• Please inform your physician and/or technologist when you arrive for your test if you have any of the following:
  • Allergies.
  • Had a reaction to Iodine or any intravenous contrast medium (if you are not sure about this, please inform your physician and/or technologist).
  • Please inform your physician and/or technologist if you have any questions and/or concerns undergoing this test and they shall be able to answer any questions and/or concerns.

About the Test

What is this test?

CT Colonography is a way of looking inside your bowel and abdomen. The following information explains the process, how it is done and what to expect. It uses a CT (Computed Tomography) scanner to produce two and three dimensional images of your large bowel (colon and rectum).

Are there alternatives to CT Colonography?

There are two other ways of looking at the large bowel: barium enema and endoscopy. Barium enema has been available for many years, and does not provide as much information and is no longer the preferred study.

Endoscopy is another way of examining the large bowel. With this test, a thin tube with a camera on the end (colonoscopy) is passed into the rectum and moved around the bowel. The procedure is more invasive than CT Colonography and usually requires sedation.

What will happen to me during the test?

• Your physician and/or technologist will explain the test to you. You will then be asked to fill your consent form to proceed. Please inform your physician and/or technologist if you had any problems with your bowel preparation.
• The test usually takes about 20-30 minutes.
• You will have a small tube - called a cannula, inserted into one of the veins in your arm.
• You will be asked to lie down on the scanner table on your left side.
• A muscle relaxant will normally be injected to avoid bowel spasm.
• You may receive contrast dye.
• The nurse will then pass a small flexible tube into your rectum.
• Air (Carbon Dioxide) will be gently introduced into your bowel through the tube in your rectum.
• Despite the muscle relaxant, you may still feel some bloating and discomfort in your abdomen.
• Following this, a quick CT scan will be acquired and a repeat scan will be acquired with you lying prone on your tummy.
• The tube will then be removed and the procedure is completed.

Are there after-test restrictions for me to follow?

• CT Colonography is generally considered a very safe test. Problems can occur, but they are rare. Problems which might occur are similar to those which can happen with other methods of examining the large bowel, these might include the following:
  • Abdominal discomfort.
  • Although the air (Carbon Dioxide) used to inflate your bowel is absorbed quickly following the procedure, some minor abdominal discomfort may remain for one to two hours. Returning to your normal diet and moving around will help to ease any remaining discomfort. Regular analgesics such as Paracetamol may be taken if you wish. To relax the muscles of the bowel wall, you may have been given Buscopan injection which can cause blurring of your vision. This is short lived and lasts for about 30 minutes. If you do experience this blurring please make sure your vision has returned to normal before driving.
  • "Faint-like" reactions.
  • Damage to the bowel wall (there may be a small tear in the lining of the colon or rectum; this is very rare and happens in less than one in 3000 tests).
• Reaction to the injected contrast. If you are given any drugs during your test, the technologist and/or the physician performing the test will give you an explanation of any potential risks or side effects that might occur.
• At the end of your test you will be allowed to get dressed and go home. You can now return to your normal eating and drinking pattern. We recommend that you drink plenty of fluids for the following two to three days.
• If you experience severe abdominal pain or generally feel unwell in the days following the test, please seek urgent medical advice with your physician or at the Emergency Department.

How will I know the results of my test?

Your test results will be sent to the physician who ordered the test. During your follow-up appointment, your physician will discuss with you the results of your test.

If you have any questions or concerns, please call our Contact Center 800 8 CCAD (800 8 2223)

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*CT Colonography Diet Sheet

Please read the instructions below and follow them to empty your large bowel before the scan. The closer you can follow the instructions then the more accurate the test will be. You should have received a drink of Oral contrast to take as below. Do not take the medication if you are allergic to IODINE and please contact the Imaging Institute.

If you are taking Iron tablets stop taking them seven days before your scan.

Two Days Before Your Scan

Do not eat high fiber foods such as:

Red meat, pink fish (e.g. salmon), fruits, vegetables, salad, mushrooms, sweet corn, cereals, nuts, seeds, bran, beans, lentils, wheat, oats, rye, barley, brown bread, brown rice, brown pasta, pickles, chutneys.

You can eat low fiber foods including the following:

Milk (2 cups/day), plain yogurt, cheese, butter, margarine, white fish or chicken (boiled / steamed / grilled), white pasta, white rice, white bread, white pitta, white flour chapattis, potatoes with no skin, egg (mashed, boiled, chipped), smooth soups (no solid bits e.g. sieved chicken noodle, tomato), clear jelly, boiled sweets, ice cream, chocolate (no fruit or nut pieces), salt, pepper, sugar, sweeteners and honey.

Have plenty to drink from tea, coffee, squash, fizzy drinks, water, clear fruit juices (e.g. apple, grape, cranberry).

The Day Before Your Scan

1. DO NOT EAT ANY MORE SOLID FOOD AFTER 8.00AM

• Prior to 8:00 am you can have a light breakfast consisting of 2 slices of white bread/toast and a boiled egg/cheese/milk.
• Do not eat any solid foods starting at 8:00 am the day before your colonoscopy.
• Start a clear liquid only diet.
• Clear liquids are liquids you can see light through, such as water, apple juice, broth, soda, tea, popsicles and jelly.
• Do not eat solid foods.
• Do not drink milk, milk products or creamers.
• Insulin or diabetes pills: please call the physician who monitors your glucose levels. Your insulin dosage may need to be adjusted due to the dietary restrictions required for bowel preparation. Please bring your diabetes and blood pressure medications with you on the day of your procedure.
• You are allowed to consume Water, Pop/Soda (Cola, 7-UP, Ginger Ale), Clear juices containing NO pulp (grape, apple, cranberry, Gatorade), black coffee, tea, (NO cream or milk - you may use sugar), Plain Jell-O, NO fruit/cream added), clear broth or bouillon.

2. MOVIPREP

Dissolve the prescribed sachet as instructed by the pharmacist.

• 0800 HOURS (8 am) - Take two sachets (A+B, one each), mix in exactly one liter of lukewarm water till it dissolves. The total volume of preparation should be one liter once you have mixed the sachets A+B (one each).
• 12 NOON - Take two sachets (A+B, one each), mix in exactly one liter of lukewarm water till it dissolves. The total volume of preparation should be one liter once you have mixed the sachets A+B (one each).

If you have heart failure or are on fluid restrictions, take PICOPREP as instructed below:

• 0800 HOURS (8 am) - Take one sachet of PICOPREP; mix in exactly 150 ml of lukewarm water till it dissolves.
• 12 NOON - Take one sachet of PICOPREP; mix in exactly 150 ml of lukewarm water till it dissolves.

3. ORAL CONTRAST

• 0800 HOURS (8 am) - Measure out 50ml of the bottle of oral contrast and take with a light breakfast.
• 12 NOON - Take the remaining 50 ml of oral contrast.

4. BISACODYL TABLET

10mg Bisacodyl tablet, oral to be taken at night before sleeping.

On the Morning of Your Scan

• Do not eat any solid food; you may drink water or clear sugary drinks.
• After the examination: You can eat normally after your test. The examination usually takes one hour.

For female patients: If there is any chance of being pregnant please inform your physician and/or technologist. If you take oral contraceptives the diarrhea may reduce their effectiveness. Continue taking oral contraceptives but use other precautions for the remainder of your menstrual cycle.