IMAGING: LOW-DOSE CT

Virtual Colonoscopy

What: The major reason for performing CT colonography is to screen for polyps and other lesions in the large intestine. Polyps are benign growths that arise from the inner lining of the intestine. Some polyps may grow and turn into cancers.

The goal of screening with colonography is to find these growths in their early stages, so that they can be removed before cancer has had a chance to develop. Most physicians agree that everyone older than 50 years should be screened for polyps every seven to 10 years. Individuals at increased risk should be screened every five years. Risk factors for the disease include a history of polyps, a family history of colon cancer, or the presence of blood in the stool.

How it works: Using a CT scanner's X-rays we will take cross-sectional images of your abdominal cavity and colon. These images will be assembled by a computer into a three-dimensional rendering allowing the radiologist to 'fly-through' or virtually examine the colon. During the study, a small enema tip is inserted into the rectum and air is used to inflate the colon.

GoLytely Preparation Instructions

Bowel Preparation Instructions:

  • Step 1:

    12:00 noon: Start to drink the bottle of GoLytely as prepared above. Please note that it may take some people longer than others to finish the entire bottle. We recommend that you start by noon, but you may start earlier if you feel more time will be needed, keeping in mind you will need to finish the bottle by 5pm. Try to drink one 8oz glass every 10 minutes. If you start to feel sick to your stomach, stop drinking until the nausea passes. Begin to drink again, but at a slower rate (an 8oz glass every 15-20 min). You must continue to drink the solution until it is all gone.

    About one hour after you start to drink the GoLytely you will likely begin to have diarrhea. You will want to stay close to a bathroom. You may also have some cramping in your lower abdomen. This is normal. Keep drinking until the prep is gone. If you start to have severe steady stomach pain, get lightheaded or dizzy, or you don’t expel any of the solution, call your primary doctor.

  • Step 2

    6:00pm (or one hour after you finish the GoLytely): Drink 250mL of Barium Sulfate

  • Step 3

    9:00pm, or 3 hours after you finish the Barium (choose one option):

    • Option A: Drink one bottle of Omnipaque. You may find it tastes better if you quickly drink it then follow it with 8oz water, clear juice or soda.
    • Option B: Mix one bottle of Omnipaque with 8oz of clear juice, soda. You need to finish all of the liquid you mix it with.

If you can’t finish the GoLytely, but your stool is clear, continue on as instructed with the barium and Omnipaque. Then call Oregon Imaging Centers CT department in the morning. We may still be able to complete your exam.

Bowel Prep Complete. You may keep drinking clear liquids until midnight.

Do not eat or drink anything after midnight the night before your exam. You may take your prescribed medicines as scheduled with a very small sip of water.

**If you have diabetes, test your blood glucose level more often when you can’t eat, as well as before your exam. You should adjust your insulin or oral diabetes medicine as discussed with your doctor. Resume your normal schedule after you receive the exam result phone call and are eating again. If your blood glucose level is low (less than 70mg/dl) or you have symptoms, please drink a clear liquid with sugar or take a glucose tablets. Keep checking your blood sugar levels to insure it stays above 70. We can still do the exam unless you need to eat solid food to maintain your blood glucose. It is better to maintain your blood glucose then to have the exam. We can always schedule your Virtual Colonoscopy in the future.

You need to pick up the Barium and Omnipaque from Oregon Imaging at our University District site. The Golightly prep will be ordered by your doctor to be picked up at a pharmacy.

Overview: Proper bowel cleaning is needed for the best exam. To get a clean and empty colon, you will start to prepare the day before your exam. Both a clear liquid diet and the contents of the bowel prep kit are needed to clean out the colon. The bowel prep kit contains laxatives and contrast medicines. The laxatives will help clean out the bowel for the exam. The contrast will help to highlight leftover stool on the CT pictures.

The day before your exam: Starting at breakfast, you may drink as many clear liquids as you want. Do not eat any solid foods. Drink only clear liquids for breakfast, lunch, dinner, and snacks. Drink plenty of fluids to avoid dehydration and make the laxative work better. Please avoid red liquids (i.e. red gelatin or cranberry juice).

Clear liquids may include:

  • Water, tea or coffee (no cream or milk; sugar is OK)
  • Sports drinks
  • Bullion or broth
  • Gelatin, ice pops (no fruit or cream added)
  • Apple or white grape juice (no orange, tomato, grapefruit or prune juices)
  • Soda such as Sprite, 7-Up, ginger ale or cola
  • Lemonade (no pulp)
  • Clear hard candy, gum

How to prepare the GoLytely Solution: (If you take other medicines, don’t take them while taking GoLytely. Take them 1 hour before starting the GoLytely or at least 1 hour after finishing the GoLytely bottle)

  • Please read the directions on the GoLytely bottle, Add water to the “fill” mark on the bottle. Shake it until all the powder has been dissolved. Do not add ice. Do not add any other liquids or flavors except, if desired, two packets of Crystal Light lemonade powder with Nutrasweet. You may do this by the glass to make it easier to drink.
  • You may find it easier to drink if it is chilled. Refrigerate but do not add ice. Because you are drinking a lot of liquid quickly you may become chilled. This is normal. It can be helped by wearing clothing or drinking the liquid at room temperature.