CT Colon Full Dose Prep (Iodine Allergy) Picolax/E-Z-CAT Bowel Prep and Diet Sheet

Patient Information Leaflet

• It is essential that you read this information and follow the instructions prior to your test.
• The success of this test depends on your colon (large bowel) being as empty as possible.
• If the colon is not adequately cleansed the test may have to be repeated.
• If you are unable to complete the preparation as instructed, please contact the Imaging Department before attending your appointment on the number above.

Please find enclosed:

• Two sachets of Picolax® (above)
• Picolax® is a laxative used to cleanse your colon prior to your test.

• One 225ml bottle of E-Z-CAT® (above)
• E-Z-CAT® improves the scan quality and contains barium sulphate.
• This is an alternative to the iodine-based X-ray dye normally used and can be taken by people who have an iodine allergy.

3 Days before your test (or from when you receive this letter):

• Stop any iron tablets, but continue to take all other medications and laxatives you usually take.

2 Days before your test:

Eat only low fibre foods, which includes the following:

• Milk (2 cups per day), plain yoghurt, cheese, butter, margarine.
• White fish or chicken (boiled, steamed or grilled).
• Eggs, tofu, white pasta, white rice, white bread.
• Potatoes with no skin (e.g. mashed, boiled).
• Clear soups (no solid bits e.g. sieved chicken noodle), Bovril, Oxo.
• Clear jelly, boiled sweets, ice cream, chocolate (no fruit or nut pieces).
• Salt, pepper, sugar, sweeteners and honey.

Have plenty to drink throughout the day:

• Water, tea, coffee, squash, fizzy drinks, clear fruit juices (e.g. apple/ cranberry).

Do not eat high fibre foods, such as:

• Fruit, vegetables, salad, mushrooms, sweetcorn.

• Cereals, nuts, seeds, pips, bran, beans, lentils.

• Brown bread, brown or wild rice, brown pasta.

• Pickles, chutneys.

• Do not eat red meat or pink fish (e.g. salmon)

The day before your test:

Diabetic patients only:

• Check blood sugar four times during the day. If at any point your blood sugar is below 5, drink clear sugary liquids to avoid a 'hypo'.

07:30 - 09:00

• Dissolve the content of the First Picolax® sachet in a cup of cold tap water (approx. 150mls).
• Stir for 2-3 minutes and drink the solution.
• If the solution becomes too hot, wait until it cools before drinking.

Breakfast (about 08:30)

• You may have 1 cup of tea/ coffee if you wish.
• Eat only low fibre foods (see list above).
• Example breakfast: 1-2 boiled eggs and a piece of white bread/toast with low fat spread.
• Drink approximately 50mls of the E-Z-CAT® now.

Diabetic patients only:

• Take insulin/ diabetic tablets with your breakfast

After Breakfast

• You may have 1 cup of tea/ coffee if you wish.
• Drink one large glass (half pint) of water or clear drink every 30-40 mins.
• Do not eat anything until lunchtime.

Lunch (about 12:30)

• Have a light lunch.
• Eat only low fibre foods (see list above).
• Do not eat bread, potatoes, fruit or vegetables.
• Example lunch: Boiled or grilled (not fried) fish/ chicken, clear soup/ bovril and any other clear drinks.
• Drink approximately 50mls of the E-Z-CAT® now

After lunch

• Drink one large glass (half pint) of water or clear drink every 30-40 mins.

3pm - 3:30pm

• Dissolve the content of the Second Picolax sachet in a cup of cold water (approx 150 mls).
• Stir for 2-3 minutes & drink the solution.
• If the solution becomes too hot, wait until it cools before drinking.

4pm - 7pm

• You may have 1 cup of tea/ coffee if you wish.
• Drink one large glass (half pint) of water or clear drink every 30-40 mins.

Dinner (between 7pm - 9pm)

• No solid food - you may drink clear soup.
• Do not eat anything until after your examination.
• Drink approximately 50mls of the E-Z-CAT® now.

After dinner and throughout the night

• Clear fluids of any type may be taken regularly before midnight.
• Drink as much water as required after midnight.

Diabetic patients only:

• Reduce your insulin dose by half, continue your diabetic tablets as normal.
• You should expect frequent bowel movements to start a few hours after taking the first dose of CitraFleet®.
• Some associated abdominal cramping is normal.
• CitraFleet® is designed to cleanse the bowel and will cause loose movements similar to diarrhoea.
• You will need to ensure you are near a toilet during this time.
• To prevent soreness, you may apply Vaseline or a barrier cream locally after each bowel action.

The day of the test:

• Do not eat anything until after your test.
• Drink clear fluids until 2 hours before your appointment.
• At 8am drink all of the remaining E-Z-CAT® solution now (approximately 75mls)

Diabetic patients only:

• If you have a Morning appointment:

  • Continue to drink clear sugary fluids.
  • Do not take anymore insulin/ diabetes tablets until after the test.
  • Check blood sugar if you can before arriving at the hospital.
  • Bring insulin/ diabetic tablets and a light meal (e.g. sandwich) with you to the hospital to have after the test.

• If you have a Afternoon appointment:

  • Continue to drink clear sugary fluids.
  • Take half your normal dose of insulin in the morning only.
  • Do not take diabetes tablets.
  • Check blood sugar if you can in the morning and before arriving at the hospital.
  • Bring insulin/ diabetic tablets and a light meal (e.g. sandwich) with you to the hospital to have after the test.

• Bowel preparation can be harmful, although this is unusual.

• There is a risk of developing dehydration, low blood pressure or kidney problems with this medication.

• The doctor prescribing the oral cleansing agent will have assessed your risk and identified the most appropriate medication for you.

• You should refer to the manufacturer's instructions when taking your preparation, however the following rules do apply:

  • The prescribed dose of oral cleansing agent should not be exceeded and should not be taken over a period longer than 24 hours.
  • Oral medication should not be taken within one hour of administration of bowel cleansing agent as it may not be absorbed.
  • Due to the risk of dehydration it is important to maintain good fluid intake whilst taking these medications.
  • If you develop symptoms of dehydration, such as dizziness, thirst or reduced urine, please seek medical attention.

Additional side effects include:

• Nausea, vomiting, bloating, abdominal pain, anal irritation and sleep disturbance.
• Allergic reactions (such as rash, itchiness, redness and swelling) - these should be reported.
• People who are particularly at risk of dehydration and loss of salts include the frail elderly, children, people with renal (kidney) impairment, cardiac (heart) failure, liver cirrhosis & those taking water tablets (diuretics).

Produced by UCLH and used with their kind permission.