Fluoroscopy

Fluoroscopy uses a continuous or pulsed X-ray beam to create a sequence of images that are projected onto a television-like monitor. When used with a contrast material (which defines the area being examined by making it appear dark or by electronically reversing the image contrast to white), this special X-ray technique makes it possible for the physician to view joints or internal organs in motion. Still images or movies are also captured and stored electronically on a computer.

What to Bring

Your physician order
Personal identification
Insurance card(s)
Medication list

How to Prepare for Your Fluoroscopy Exam (Lower GI)

If there is any chance you may be pregnant, your exam should be postponed until the start of your period or within 10 days after. If there is any possibility that you are pregnant, you should always inform your X-ray technologist.
If you are having an exam that requires you to be fasting, do not eat or drink anything including water after midnight before your exam.
Certain exams can take as long as 4 hours.
If you have an on-body device (insulin pumps, insulin regulators, Neulasta, other chemo pumps, etc), you must inform your X-ray technologist. These devices cannot be in the X-ray room during your exam.

How to Prepare for Your Lower GI Exam (Barium Enema)

Please let your physician know about any medications you are taking and if you have any allergies, especially to contrast materials.
Please inform your doctor about recent illnesses or other medical conditions.
You will be required to perform a bowel prep beginning 2 days before the exam. (See Below)
Infants and children may undergo lower GI radiography. Usually, there is no special preparation, but your doctor will give you detailed instructions to prepare your child for the examination. The use of barium and the taking of x-ray images are similar to that described for adults.
A barium enema is usually not appropriate for someone who is in extreme abdominal pain or who has had a recent colon biopsy. If perforation of the colon is suspected, the enema should be performed with a water-soluble contrast solution.

Please have the following items on hand the day before your procedure which can be obtained through local pharmacy:

10 fluid ounces magnesium citrate (1.7 gram per ounce – any brand name)
4 bisacodyl tablets 5 mg (any brand name laxative tablet)
1 bisacodyl suppository 10 mg (any brand name)

Day Before Procedure

Breakfast: clear soup (any broth), strained fruit juice without pulp, flavored gelatin, soft drinks, black coffee or plain tea

Lunch: clear soup (any broth), strained fruit juice without pulp, flavored gelatin, soft drinks, black coffee or plain tea

1:00 p.m. - drink one (1) full 8-ounce glass of water
2:00 p.m. - drink one (1) full 8-ounce glass of water
3:00 p.m. - drink one (1) full 8-ounce glass of water
4:00 p.m.- drink one (1) full 8-ounce glass of water
5:00 p.m.- clear soup (any broth), strained fruit juice without pulp, flavored gelatin, soft drinks, black coffee or plain tea
5:30 p.m.: drink entire bottle of magnesium citrate oral solution. This product generally produces a bowel movement in 30 minutes to 6 hours.
6:00 p.m. - drink one (1) full 8-ounce glass of water
7:00 p.m. - drink one (1) full 8-ounce glass of water
7:30 p.m.: Swallow all four (4) enclosed bisacodyl tablets with 8 ounces of water. Do not chew tablets. The tablets are to be taken two hours after drinking the magnesium citrate solution. Bisacodyl tablets generally produce a bowel movement in 6 to 12 hours.
8:00 p.m. - drink one (1) full 8-ounce glass of water
9:00 p.m. - drink one (1) full 8-ounce glass of water
DO NOT EAT AFTER 9:00 p.m.

Day of Procedure

At least two hours before exam, unwrap the foil wrapper from the bisacodyl suppository and discard the foil. Follow the instructions for insertion of the suppository.
Retain the suppository for at least 15 minutes if possible before evacuating, even if the urge is strong. Bowel evacuation usually occurs within 15 to 60 minutes.
You should take your usual prescribed oral medications with limited amounts of water.
Leave all valuables at home.
You will be given a gown to wear during the procedure. You may be asked to remove jewelry, glasses and any metal objects or clothing that might interfere with the X-ray images.
After the procedure, drink plenty of clear fluids.

What to Expect

The lower GI examination is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
Lower gastrointestinal tract radiography or “Barium Enema” uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material or another water soluble iodinated contrast to produce images of the lower GI tract (large intestines/bowel)
It is safe, noninvasive, and may be used to help accurately diagnose pain, blood in the stool and other medical conditions.
A radiology technologist and a radiologist will guide the patient through the lower GI exam.
The patient is positioned on the examination table and an X-ray film of the abdomen is taken to ensure the bowel is clean.
The radiologist or technologist will then insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium contrast or another water soluble contrast into the colon.
Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon.
A series of fluoroscopy images and X-ray images will be taken throughout the exam.
You must hold very still and may be asked to hold your breath for a few seconds while the X-ray picture is taken to reduce the possibility of a blurred image.
The patient may be repositioned frequently in order to image the colon from several angles.
Once the X-ray images are completed, most of the contrast will be emptied through the tube. The patient will then expel the remaining contrast and air in the restroom. In some cases, additional X-ray images will be taken.
A lower GI exam is usually completed within 30 to 60 minutes.

What will I experience during and after the procedure?

As the contrast fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure or even minor cramping. Most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the contrast. If you are having trouble, let the technologist or radiologist know.
During the imaging process, you will be asked to turn from side to side and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel (air contrast barium enema), the table may be moved to an upright position.
After the examination, you can resume a regular diet and take orally administered medications unless told otherwise by your doctor. You may be able to return to a normal diet and activities immediately after the examination. You will be encouraged to drink additional water for 24 hours after the examination.
Your stools may appear white for a day or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need an enema or laxative to assist in eliminating the barium.