Patient Information

Radiology

CT colonoscopy

© Cancer Research UK [2002] All rights reserved. Information taken 21/06/2019

Appointment detail & information

Your consultant has referred you for a CT colon examination.

You will already have been invited to attend an appointment at the

hospital to collect any contrast you need to take prior to your
appointment. All aspects of this procedure will have been explained
to you and the following notes are purely a reminder of what has
already been discussed with you.
Patient Information

This leaflet will explain the bowel and diet preparation you are required to
follow prior to your examination. Failure to follow these instructions will
result in poor quality images, from which early cancers may not be
identified.

Please note that this leaflet contains important safety information – you
must read the entire leaflet before proceeding.

This booklet is aimed to give an explanation as to what the examination

involves. It may not answer all your questions. It is aimed to help you make
a decision on whether to agree to this test. The test involves drinking some
X-ray dye 48 hours prior to your scan and following a strict bowel cleansing
diet.

Please read this leaflet carefully to make sure you successfully

prepare for the examination. You will need to begin your preparation
for the examination 2 days before your appointment.

Points to remember
• Please complete the attached safety questionnaire and bring it with
you to your appointment.
• Please arrive in the department at least 15 minutes before your
appointment time. This is so that we have time to go through your safety
questionnaire, and get you appropriately changed for your examination.
• If you are on medication from your doctor, except insulin and iron tablets,
please continue to take it as normal. Please continue to take your
heart medication.
• We suggest that you wear loose clothes to this appointment as you may
feel bloated for a short while afterwards. We also ask you to leave any
valuable possessions at home.
• If you are diabetic, you should not take your morning insulin prior to the
examination. Please bring your own insulin, any instructions you have
for taking it, and a light snack for after the examination with you.
• If you are on peritoneal dialysis, you must ensure the CAPD fluid is
drained prior to the CT colon appointment. Please make any necessary

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Patient Information

arrangements with the dialysis ward or your home care nurse for this to
be done in time for your X-ray appointment.

What is CT colonography?
A small tube will be inserted into your rectum, and then the trained
radiographer will administer some carbon dioxide (CO2) gas.

Will I have an injection?

You will usually have a small injection of smooth muscle relaxant
(buscopan) into a vein in your arm to reduce any spasm that may occur in
your bowel. This makes the examination more comfortable for you and
helps us to get the best possible images.

You may also need an injection of X-ray dye through a small cannula
(tube) in a vein in your arm. This is not always necessary. The
radiographer will explain this to you at the time.

Why do I need to have a CT colonography scan?

Your referring doctor, together with a consultant radiologist, has agreed it
is best for your care that your bowel is imaged with this approach. You will
have been referred for this investigation to try and find the cause of your
symptoms, to help with treatment, and, if necessary, to help decide on
further investigation.

Information for National Bowel Cancer Screening

patients
Patients on the bowel cancer screening programme are usually only
offered this test because colonoscopy is not suitable for you. Someone
from the screening programme should have discussed your options with
you, but the main benefits and disadvantages of CT colonography are
outlined here:
• A CT colonography scan can detect cancer and polyps at an early
stage. This improves your chances of successful treatment and survival.

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Patient Information

• The investigation is generally considered less invasive than

colonoscopy.
• There are some common minor side effects, and some very rare but
more serious risks such as perforation of the bowel.
• A CT colonography scan delivers a dose of radiation, but this carries a
very low risk.
• It is possible that, as with colonoscopy, CT colonography scans may
miss a polyp or a cancer.
• If a polyp or cancer is identified with this scan, you may still have to
have a colonoscopy to further your diagnosis.

What are the alternatives?

A colonoscopy is the standard examination for the colon and is performed
in the endoscopy department. This is more invasive than a CT
colonoscopy and usually requires the patient to be sedated. The procedure
also allows for tissue to be removed for testing (biopsy) or removal of
polyps if required.

Your doctor will have discussed these alternatives with you and why CT
colonography has been chosen as the most appropriate test for you.

What is a CT scan?
A CT scan is an X-ray examination which provides multiple highly detailed
images in a matter of seconds.

You will be required to lie down on the CT bed which will move through the
scanner. It is most likely you will be scanned on your back, tummy, and
possibly on your side. During your scanning process, you will have a very
bloated tummy which will be full of air.

There will be an X-ray dose associated with this examination for which you
have consented to undertake.

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Patient Information

Are there any side effects?

Your preparation and diet is designed to make your stools very loose and
give you diarrhoea. The X-ray dye has a metallic taste which you can
disguise with squash. Although it is unlikely to make you sick, some
people may feel nauseous.

A very few people may suffer an allergic reaction (such as hives, rashes,
itching). Do not continue with your prep and consult a doctor if this
happens. Perforation of the bowel can occur with this test, but this is very
rare (around 1 in 3000 tests). When it happens, most cases resolve
without treatment, but you may require hospital admission and observation
under the care of a surgeon. Serious complications are rare.

Important safety information

Please call 0247 696 6952 and let us know before starting any prep if
any of the below applies to you:
• You have difficulty swallowing
• If you have a colostomy, ileostomy, or jejunostomy (stoma). You
may require an alternative test that will have different preparation
instructions to this one. You should not drink the gastrografin, as it
will cause diarrhoea.
• Your weight is more than 23.5 stone (149kg)
• You have prostatism
• You are allergic to iodine or have reacted previously to the injection
used in X-ray to show your kidneys, blood vessels (angiography) or for
CT scanning.
• Have hyperthyroidism
• Have a medical condition known as broncho-oesophageal fistula (a join
between your windpipe and gullet)
• You have been treated with interleukin-2
• You have been diagnosed with a fluid/electrolyte imbalance
• You have severe renal impairment (GFR less than 30ml/min)
• You suspect you may be pregnant

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Patient Information

Please inform the radiographer carrying out your test

if you:
• Have had a heart attack in the last 6 months
• Are waiting for heart surgery
• You suffer from angina or heart arrhythmia
• Are unhappy to proceed with this test

Patients aged 12 to 55 years (for all examination

between diaphragm and knees):
• The risks of radiation are slightly higher for the unborn child. You will be
asked to confirm that you are not pregnant before an examination can
proceed.
• To ensure there is no possibility you are pregnant, your examination
should be performed within the first 10 days of the start of your
menstrual cycle.
• If you are outside of this window, we ask that you read and complete
the Confirmation – ‘I am not pregnant’ form which is attached before
attending your appointment.
• Should you have any doubt, we advise that you take a pregnancy test to
confirm.
• If you have any questions or require more information, please contact
the CT department on 0247 696 6952 (Monday to Friday, 9am to 5pm)
and ask to speak to the bookings clerk in advance of your appointment
date.

How do I prepare for the scan?

• If you are diabetic, please contact your named nurse/GP if you have
any queries regarding your medication whilst preparing for this
examination.
• If you are on a fluid restricted allowance: if you are under the care of
a renal specialist and/or have to follow a fluid restricted diet, you should
include this preparation as part of your fluid allowance. If you pass a lot
of fluid in your bowel motions after taking the medication, you can relax
your fluid restriction to prevent dehydration. If you are unsure about your

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Patient Information

fluid allowance in relation to the contrast effect, please seek advice from
your home care nurse, dialysis nurse, or kidney specialist
• If you are taking iron tablets: you must stop these 7 days before
your CT colonoscopy.

Stage 1: 2 days prior to your examination

• For breakfast and lunch, you need to follow a low residue diet (example
diet below). You may eat only from the foods listed below and you must
not eat fried food.
• After lunch, do not eat any more solid food until after your scan.

You can still have clear or strained soup, jelly, ice cream, custard,
Complan meal substitute drink, Bovril or Oxo drinks, water, squash, fizzy
drinks, tea, and coffee.

Make sure you drink plenty whilst following the low residue diet. Have at
least 3 pints (1700ml) of fluids spaced out over the day. This can include
tea or coffee with a dash of milk, squash, fizzy drinks, water, fruit juice with
no bits, Oxo, Bovril and clear soups.

Do not eat high fibre foods such as:

Red meats, pink fish (e.g., salmon)

Fruit, vegetables, or salad

Cereals, nuts, seeds, pips, bran, beans, or lentils

Brown bread, brown or wild rice or brown pasta

Pickles, chutney jams or marmalade

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Patient Information

Low residue diet example:

Breakfast • Boiled egg
• White bread with margarine or butter
• Crisped rice breakfast cereal

Mid-morning • Tea or coffee with a dash of milk

• Have a Rich Tea biscuit or Marie biscuit if you
normally have a snack

Lunch • Grilled/poached or steamed chicken without skin

• Cooked white rice or pasta (not wholemeal), white
bread, white pitta, or white flour chapatti
• Tea or coffee with a dash of milk

Mid-afternoon • Tea or coffee with a dash of milk

• Have a Rich Tea biscuit or Marie biscuit if you
normally have a snack

Evening meal • Strained soup or consommé (no bits)

• White bread (your normal amount) with margarine
or butter

At 7pm, drink ½ the bottle (50mls) of gastrografin

diluted in at least the same amount of water or
fruit squash.

Bedtime • Tea or coffee with a dash of milk

• Have a Rich Tea biscuit or Marie biscuit if you
normally have a snack

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Patient Information

Alternative low fibre foods

White fish boiled/ steamed/ grilled

Eggs, Tofu

Clear soup (no bits e.g., sieved chicken noodle)

Boiled sweets, plain ice cream (no nuts or fruit or bits)

Salt, pepper, sugar, sweeteners, and honey

Stage 2: 1 day before your examination

• You should not eat solid food from today until after your examination
tomorrow.
• If you are diabetic: continue with your normal insulin or tablets. If you
are on insulin and normally eat large portions of carbohydrate foods, you
will require more milk, Build-Up, Complan or ordinary squash. Please
adjust your insulin to match your carbohydrate intake.

Drink at least 3 pints of fluid spaced out over the day. This can include tea
or coffee with a dash of milk, squash, fizzy drinks, water, fruit juice (no
bits), Oxo, Bovril and clear soups.

Breakfast • Tea or coffee

• You may have 1 sachet Build-up + ½ pint skimmed or
semi-skimmed milk or 1 serving of Complan

Morning • 1 glass of milk or 1 glass fruit juice (no bits)

snack

Lunch • Clear or sieved soup, OXO, Bovril or Marmite drinks if

desired.
• 1 sachet Build-Up + ½ pint skimmed / semi-skimmed
milk or 1 serving of Complan

Afternoon • 1 glass of milk or 1 glass fruit juice (no bits)

snack

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Patient Information

Evening • Clear or sieved soup, OXO, Bovril or Marmite drinks if

meal desired.
• 1 sachet Build-Up + ½ pint skimmed / semi-skimmed
milk or 1 serving of Complan

At 7pm drink the remaining ½ the bottle (50mls) of

gastrografin diluted in at least the same amount of
water or fruit squash.

Late snack • 1 glass of milk or 1 glass fruit juice (no bits)

Stage 3: The day of your examination

• Do not eat solid food. Drink clear fluids only.
• If you are diabetic: do not take your insulin or tablets on the morning of
your examination. Bring your medication and something to eat with you
to the hospital, to take after your examination.
• If you take heart medication, please take it as normal.

After the examination

• You will be given an aftercare information sheet by the CT staff.
• If you have any problems after the examination, please see your GP.

How do I get the results?

• They will be sent to the doctor who referred you for this examination.
You will not be given the results on the day of the examination.

Other sources of information:

• For information about the effects of X-rays read the NRPB publication:
“X-rays how safe are they?” on the Health Protection Agency website:
[Link]

Please note that the views expressed in these websites do not necessarily
reflect the views of UHCW NHS Trust or the NHS.

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Patient Information

The Trust has access to interpreting and translation services. If you need
this Information in another language or format, please contact 0247 696
6952 and we will do our best to meet your needs.

The Trust operates a smoke free policy.

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We would like you to tell us what you think about our
services. This helps us make further improvements and
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Have your say. Scan the QR code or visit:
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Document History
Department: Radiology - CT
Contact: 26952
Updated: September 2022
Review: September 2024
Version: 8
Reference: HIC/LFT/1355/11

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 Patient Sticker

Patient Information

Confirmation – ‘I am not pregnant’

The hazard associated with the irradiation for an unborn foetus has been explained to me as
follows.
There is a small (1 / 1000 to 1/ 100 000) risk of developing childhood cancer from
prenatal exposure to radiation. This is considered to be a low risk.
If you can say ‘yes’ to any one of the statements in the table below, we consider it very unlikely
that you are pregnant.
If you cannot say yes to any of the following statements, or you are in any doubt, you are
advised to take a pregnancy test to confirm that you are not pregnant before proceeding with
the test.
*IMPORTANT INFORMATION: The combined oral contraception pill is considered to be highly
reliable if taken exactly as described within the drug patient information leaflet. It may become
unreliable if doses are delayed/omitted, if the patient suffers from diarrhoea / vomiting or it is
taken with certain antibiotics

• I have had a hysterectomy or I am sterilised or I am infertile and not

having infertility treatment.
• I have not missed a period and I have not had sexual intercourse since
the beginning of my last period.
• I use a highly reliable form of contraception e.g. injection / implant/ coil.

• I use the combined oral contraceptive pill as described in the patient

information literature provided in its packaging *see footnote
• I am post-menopausal and I have not had a period for two years and I
am not undergoing fertility treatment
• Young person and not yet started periods

• I have not missed a period and I have had a negative pregnancy test
since last sexual intercourse

• I am currently undergoing radiotherapy to my pelvic region

I understand that this document will be kept by the UHCW Radiology Department.I wish to
proceed with my examination today and I am certain, for one of the reasons listed above, I
am not pregnant.

PATIENT’S SIGNATURE……………………………………………………..

DATE…………………………………………………………………………….

RADIOGRAPHER’S SIGNATURE……………………………………………

On completion of this form, it must be scanned onto Soliton within the patients’ examination
information.

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Patient Information

CT Safety Questionnaire
NAME: D.O.B.
ID check:
ADDRESS:

HOSPITAL NO: Male / Female Yes No

• Have you taken the bowel preparation and followed the diet?

• Have you had a recent Digital rectal exam?

• Have you had a CT scan before?

If outside of the Warwickshire area, please state where and when.
• Have you had an injection of contrast medium before?
• Have you ever had an adverse reaction to an injection of contrast medium?
• If YES, please give details:
• Are you allergic to anything?

• Do you have any of the following:

- Angina, heart failure or atrial fibrillation
- Untreated Glaucoma
- An enlarged prostate that causes urinary retention
- Megacolon, myasthenia gravis or paralytic ileus
- Thyroid disease
• Do you have asthma or COPD?

• Do you have any of the following:

- Diabetes- If yes, do you take Metformin or Glucophage?
- Sickle cell anaemia
- Myeloma- If YES, please ensure you are well hydrated before this
procedure.
• Do you have renal failure, see a kidney specialist, or have dialysis?

• May we use your images for teaching purposes?

Patients aged 12-55 years only

11. What date did your last period start? Date: .....................................
- Are you currently breastfeeding?
- Could you be pregnant?

I have read the information sent with my appointment letter. I understand the nature,
risks and benefits of this examination and wish to proceed.

Patient signature: ……………………………………… Date: …………………………………..

Radiographer/Radiology Assistant: …………………………… Height/Weight: …………………..

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Patient Information

For staff use only:

On Table review-

If buscopan not given, why?

Extra View completed- Reason and

segment done for.
Series and slice number

Area of concern on 1st read. Thorax

added?
Series and slice number

Litres of CO2 administered

Was tube balloon deflated for 2nd view?

Drugs given: Volume Lot number Expiry date:

Cannulation label

By signing this document, I confirm that:

Pause and Check has been completed.
Drugs administered to the patient have been checked. (If appropriate)
The cannula has been removed (if appropriate).
An aftercare sheet has been provided (if appropriate)
All patient property has been returned.
The images for this scan have been appropriately archived.

Radiographer: …………………………………..
Registered member of staff: …………………………………
Radiology Assistant: ………………………………….

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