VIRTUAL COLONOSCOPY EXAMINATION PREPARATION



CT VIRTUAL COLONOSCOPY EXAMINATION.

VIECURI Medisch Centrum, Venlo, the Netherlands.

Dear sir, madam,

You have been scheduled for a CT scan of your colon (= large bowel).

During this examination your abdominal organs are going to be investigated with help of x-rays. This will result in photographic cross-sectional views of your abdomen.

The main interest of this examination is the investigation of your colon. To make the colon structures better visible, air insufflations and if necessary a contrast injection is needed. Please find below all the necessary information and read this thoroughly.

The examination:

A CT examination is performed with a Computed Tomography scanner.

This CT scanner produces digital views of your body, and in this case particular of your colon, and gathers the information needed for diagnosis and for treatment of your medical complaints.

You have to undress for this examination, so please bring a large t-shirt without buttons to wear during the examination.

At the start of the examination you lie on your left side, on the table.

As air insufflation is needed to get the best results, the technician will insert a small catheter in your anus. This small catheter is used for the air insufflations. This might give an uncomfortable (blown-up) feeling, but it is important that you try to keep the air in your colon as well as possible.

To help to extend the colon you will get an injection of Buscopan (= harmless medication).

After the air insufflations the first scan series will be made while you are lying on your back (supine), the second scan series is made when you are lying on your stomach (prone). One scan series takes +/- 20 seconds; you will get breathing instructions before the scan starts and the table will move during scanning. It is important not to move during scanning.

The technician will be in the control room while (s)he is scanning, but you can talk to her/him via the intercom.

When the scanning procedure is finished, the catheter will be removed and you can use the toilet. Please take the time for this.

It might happen that in a special occasion a contrast injection is needed. This will be done via a needle in your arm vein.

The total examination time will last between 15 to 30 minutes.

VIRTUAL COLONOSCOPY EXAMINATION PREPARATION

It is very important that the colon is as clean as possible before the examination. Therefore we have composed the following diet which you have to follow during 2 days before the examination. Please take the laxative material that has been given to you and follow the instructions carefully.

In case it is necessary to change to preparation, your physician will contact the radiologist.

2 days before the examination:

Breakfast (08.00 – 09.00)

- 2 slices of white bread with margarine, 1 with a slice of plain cheese, 1 with jam (without any seeds or fruit skin material)

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

In betweens (09.00 – 12.00) don’t eat, only drink:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

Warm meal (12.00 – 14.00):

- 2 cups of soup prepared from clear stock/broth** with pieces of cooked chicken (without skin) or fish, starched or filled with noodles

- Optional a portion “drink-food”***

- 1 glass of apple juice or lemonade (without gas)

In betweens (14.00 – 17.00) don’t eat, only drink:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

Evening meal (17.00 – 19.00)

- 2 slices of white bread with margarine, 1 with a slice of plain cheese, 1 with jam (without any seeds or fruit skin material)

- 1 cup clear stock/broth, without fat**

- Optional a portion “drink-food” ***

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

Later in the evening:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

1 day before the examination:

Before the breakfast (ultimately 08.00):

- Drink 1 bottle magnesium sulfate (= 150 ml)

- 2 tablets Bisacodyl (= 2 x 5 mg) with a glass of water

Breakfast (08.00 – 09.00)

- 2 slices of white bread with margarine, 1 with a slice of plain cheese, 1 with jam (without any seeds or fruit skin material)

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

In betweens (09.00 – 12.00) don’t eat, only drink:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

Warm meal (12.00 – 14.00):

- 2 cups of soup prepared from clear stock/broth** with pieces of cooked chicken (without skin) or fish, starched or filled with noodles

- Optional a portion “drink-food”***

- 1 glass of apple juice or lemonade (without gas)

In betweens (14.00 – 17.00) don’t eat, only drink:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

Evening meal (17.00 – 19.00)

- 2 pieces of plain cheese, eventual with mustard

- 1 cup clear stock/broth, without fat**

- Optional a portion “drink-food” ***

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

Evening (2 hours after evening meal)

- 2 tablets Bisacodyl (= 2 x 5 mg) with a glass of water

Later in the evening:

- 2 cups of coffee, tea, or other clear drinks* ( no milk or milk products)

- 1 glass of apple juice or lemonade (without gas)

IMPORTANT:

At 20.00 hr: You have been given a bottle of E-Z-Cat. This should be diluted with water till 1 liter. You have to drink 1 glass of this fluid every 10 minutes.

Day of the examination:

Breakfast (08.00 – 09.00):

- 1 cup of tea and a biscuit with a small slice of plain cheese or jam (without seeds or any fruit skin material)

Explanation * I ** I ***

*Clear drinks: (mineral) water, tea, coffee (with a little sugar and no milk), lemonade without any pieces of fruit, apple juice, grape juice, berry juice.

** Clear de-greased stock or broth can be made of a broth cube. In case home-made stock or broth is prepared, take the fat off after the stock is cold and pass the fluid through a sieve.

***”Drink-food” is a high energy diet drink, which gives a satiated feeling. It is available in packages of 200 ml. In the Netherlands it can be purchased at the pharmacy, but is not refundable in your medical insurance.

N.B. 1. The above diet with the laxative pills can have a negative influence on the function of the anti-conception pill.

N.B. 2. In case you have other medication, it can be taken as normal during this diet

N.B. 3. It is important that you follow the instructions for the diet accurately. If you don’t, there is a big chance that part of food will stay in the colon. This make the diagnosis very difficult and can lead to re-do the examination.

Contra-indications

Allergy:

IN CASE YOU ARE ALLERGIC FOR IODINE, PLEASE INDICATE THIS UP FRONT TO YOUR PHYSICIAN AS WELL AS AT THE X-RAY DEPARTMENT

Pregnancy:

X-ray examinations can hurt the un-born child. In case you are pregnant or think that you are pregnant, please discuss this with your physician.

Side effects

In case a contrast material has to be injected via a needle in your (arm) vein, it is possible that some effects can occur. Some patients can get an allergic reaction like vomiting, sneezing, or skin reactions. The contrast material contains iodine, and it is important that you indicate up-front if you have known allergy against this material.

After the examination

Minor abdominal pain can occur after the examination; this will usually disappear quickly. To make sure that the contrast material you had to drink will not stick in the colon it is important that you drink a lot of fluid. If you don’t have normal stool after 2 days, it can help to take laxative pills to prevent constipation. You can buy these pills at the pharmacy.

After the examination you can eat and drink as you are used to do.

Reporting or diagnosis

The report of the diagnosis of this CT examination will be given to you by your physician.

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