CT Virtual Colonoscopy

This information booklet tells you about virtual colonoscopy, which is a test to look for possible abnormalities of the bowel. It also explains how the test is done, the risks involved and what to expect. What is virtual colonoscopy? CT stands for Computed Tomography, which is a way of using X-rays to produce slices of images through the part of the body under examination. This test is also known as CT colonography. Virtual colonoscopy involves using a CT scanner to produce two and three dimensional images of the whole of the large bowel (colon and rectum). The CT machine opening is very wide and you will not be enclosed in any way. The scanner makes a little more noise than a normal x-ray machine During a virtual colonoscopy, gas will be used to inflate the bowel via a thin flexible tube placed in your back passage. CT scans are then performed with you first lying on your back and then on your front. In this way, doctors can then look at the images for polyps or signs of cancer. If anything unusual is seen on the scan, you may require an endoscopy for a sample to be taken (biopsy) at a later date. Your doctor will discuss this with you if it is required. 1

Are there alternatives to a virtual colonoscopy? There are other ways of looking at the large bowel, but your doctor has decided that this is the right test for you. Alternative tests are barium enema and colonoscopy (also known as endoscopy or camera). Barium enema is rarely performed now as it does not provide as much information and is less comfortable for patients. Endoscopy is where a thin tube, with a camera on the end, is passed into the back passage and moved up and around the bowel. It is the standard test for the large bowel. However, it is more invasive than virtual colonoscopy and usually requires sedation, but it does allow tissue biopsy or polyp removal if needed. What do I have to do before my virtual colonoscopy? Bowel preparation To give us a clear view of the bowel lining, your bowel has to be prepared before the test. This will involve clearing the bowel of faeces using a mild laxative. You may be asked to drink an iodine or barium-based tagging liquid with meals 1-2 days before having the test. You may also be asked to do either or both of these preparations You will be given a leaflet explaining this preparation in more detail. It also provides dietary instructions regarding what you should or should not eat before your test. Please let us know when you arrive in the department if you can answer yes to the following: l Type 2 Diabetes - you can also contact the Diabetes Centre using the contact details on page 4 l Asthma l Kidney problems l Glaucoma l Prostate problems l Angina l You have had a heart attack in the last six months l You are waiting for heart surgery l You are waiting for a coronary angioplasty l You have any allergies l If you have had a reaction to iodine or intravenous contrast (dye) before please let us know as soon as you receive this appointment and do not take the preparation until you have spoken to a member of CT staff continued page 4 2 3

Patients with Diabetes If you are a female patient up to the age of 55 and not had your period within 10 days of your appointment date, then please ring the department as you will require a pregnancy test before your scan. If you think you may be pregnant, you must inform the CT Staff before arriving for your examination. Please use the contact details at the end of this booklet. Taking tablets and medicines If you take Metformin (Glucophage) tablets for diabetes, please let us know on the day of your test. We sometimes ask patients to stop these tablets for two days after the test. You should continue to take all your other tablets. If you are diabetic and you need advice about your medication and diet, please contact the Diabetes Centre on: 0161 212 2095 Monday to Friday 8.30am to 12.30pm as soon as you receive this appointment and ask to speak to a diabetes specialist nurse. You may have an injection to relax the bowel and reduce spasm. If you are given this injection you cannot drive for 1 hour after the injection. If you have any questions, please ring the: Radiology Booking Office on: 0161 206 2044 0161 206 2404 0161 206 7028 Monday to Friday 8.30am to 4.00pm Where do I go when I arrive at the hospital? You should go to: Radiology 2 Reception, Ladywell Building A receptionist will check you in for your appointment and you will be given instructions on undressing and putting on a hospital gown. If you need help with changing please bring someone with you if you are able to do so. Please bring a dressing gown with you as CT changing rooms are shared with other departments. What happens when I am ready for my scan? You should be seen within 30 minutes of your appointment time. But please remember that we sometimes have to scan emergency cases, which means you may have to wait longer. You will be told when you arrive how long you will have to wait. You may want to bring a book or newspaper with you to help you pass the time. 4 5

What happens during virtual colonoscopy? l The Radiographer will explain the test and answer any questions. They will ask you some questions before they do the test. Please let him/her know if you have had any problems with your bowel preparation l The procedure will then take about 15-20 minutes l You may have a cannula (small needle) inserted into one of the veins in your arm l You will be asked to lie down on the scanner table on your left side l The Radiographer will pass a short, thin flexible tube into your back passage l A muscle relaxant may be injected through the cannula in your arm which helps to ease bowel spasm l You may be given an injection of contrast( dye) via the cannula. This dye is iodine based l Gas (carbon dioxide) will be gently introduced into your bowel through the tube in your back passage, this is done at a controlled rate by a machine specifically designed for this purpose l Despite the muscle relaxant, you may still feel some bloating and mild discomfort in your abdomen like bad wind l Once the Radiographer is satisfied with the amount of gas in your large bowel, a CT scan will be taken with you lying on your back l You will then be asked to turn on to your front for a second scan l Each scan will take about 10 to 20 seconds (1 breath hold) l On completion of the test the tube will be removed and you will be shown to a toilet Are there any risks? Virtual colonoscopy is generally regarded as a very safe test. Problems can occur rarely, and if they do, they are similar to those which could happen with other methods of examining the large bowel. These include the following: l Abdominal discomfort l Faint-like reactions l Reaction to the injected contrast or the muscle relaxant l Damage to the bowel wall (a small tear in the lining of the colon or rectum may occur rarely (fewer than 1 in 3000 tests) What happens after the test? Once the test is finished you can eat and drink normally. The radiographer will give you an after CT information leaflet. Please remember If you are given the injection you should not drive for 1 hour after the injection. The radiologist (x-ray doctor) reviews the examination once you have left the department and writes a report to your specialist. The results will be sent to the doctor who requested the examination, and they will contact you at a later date. When you attend for your next clinic appointment, your specialist will explain to you what the results mean Your doctor will decide if further tests or treatment are needed. The radiographers who perform your procedure are not permitted to give you results or discuss the meaning of your results with you. 6 7

What if I cannot attend for my appointment? If you have any questions about your examination or cannot make the appointment, please telephone the Booking Office on: 0161 206 2044 0161 206 2404 0161 206 7028 0161 206 7029 0161 206 4006 Monday to Friday 8.30am to 4.00pm If you are not able to telephone please contact us via email on: booking.radiology@srft. nhs.uk Please include your name, address, date of birth and hospital number (if known) on all correspondence Interpreters If you need an interpreter for your examination please call the department so that we can try to arrange this, or there will be information about translation services on the back page of this booklet. I need an ambulance, how do I arrange this? If you need an ambulance there are contact details on your appointment letter. Please inform the booking office if you are travelling by ambulance using the telephone number above. Other sources of information Your questions should have been answered by this booklet, further information regarding the examination can be found on the Internet. Websites For general information about radiology departments, visit The Royal College of Radiologists website: www.goingfora.com www.rcr.ac.uk when less urgent than 999 NHS 111 Service 111 NHS Direct www.nhsdirect.nhs.uk If you need further help or information please contact: CT Scan Department, Radiology, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD 0161 206 1233 In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities to access this service. Please help us to cut our waiting lists. If you need to cancel or change your appointment call us as soon as you can, so that we can give it to another patient. 8 9

G13092406W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2015 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: CS68(13) Review Date: January 2017 For further information on this leaflet, its references and sources used, please contact 0161 206 1233 Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Under the Human Tissue Act 2004, consent will not be required from living patients from whom tissue has been taken for diagnosis or testing to use any left over tissue for the following purposes: clinical audit, education or training relating to human health, performance assessment, public health monitoring and quality assurance. If you object to your tissue being used for any of the above purposes, please inform a member of staff immediately. Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on 0161 206 1779 Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone 0161 789 7373 www.srft.nhs.uk If you would like to become a Foundation Trust Member please visit: www.srft.nhs.uk/ for-members If you have any suggestions as to how this document could be improved in the future then please visit: http://www.srft.nhs.uk/ for-patients