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Pneumocolon Scan

(9 Posts)
carmen66 Sat 06-Oct-12 07:25:05

Hi, for quite a while now I have been suffering with diahorrea on a daily basis.. It's when I wake up & I can go anything between 2-3 times then I'm fine until the folllowing morning.. All my blood tests are normal however my GP referred me to the Colorectal dept for a Sigmoidoscopy ..I waited 8 weeks for the appt which was last Friday the consultant advised against a Sigmodoscopy because I have anxiety & plus I have no other symptoms i.e bleeding or cramping..
She has advised a Pneumocolon CT Scan which mean's a cannula injected with contrast dye to get a better picture of my colon... I'm so scared of the procedure after reading what it involves I'm very concerned about the amount of radiation going into my body.. I have had xrays in the past & one CT scan for a nasal problem which involved contrast dye.. Has anybody else had this done? please help I am at a stage now I'm convinced that it could increase my chances of cancer later on ridiculous I know ;-(

LittenTree Sun 07-Oct-12 14:09:50

Every xray exam is pre-assessed for radiation 'risk' against benefit of diagnosis or ruling something out.

If you can't or won't have the camera-up-the-undercarriage grin examination, the next best thing is the CT pneumocolon. They're often chosen over a colonoscopy if a person is too frail for colonoscopy; can't be fully prepped for one; one 'fails' ie they can't get the camera all the way around or colonoscopy is refused.

The way it is usually done involves the equivalent of 2 CT abdomen/pelvis exams in that you're often imaged lying on your back, then on your front. This allows any loose 'solids' to move from a to b. Bumps that don't move can be regarded as suspicious.

Every dose of radiation carries a risk, but it must be put in proprotion. this might be useful, but you need to bear in mind that we are exposed to radiation every day of our lives, more or less depending on where we live and what we do! Some parents won't allow Tybalt to have a knee xray 'because of the dose' then put him on a plane for 7 hours to the holiday villa in St Lucia the next...

The reality is that 'a few xrays and a facial CT in the past' might have already have induced cancer in you! Statistically it's highly unlikely but that's how radiation works. Somebody else can have endless doses and never get a detectable cancer. Yes, the latter person's statistical risk is higher but it doesn't protect the former.

That's why there are no 'limits' to the highest does you can receive.

Maybe it would help you to ask your referring doctor what, exactly, they think they might find. You need to ask your doc this, not the radiographer who does the pneumocolon. The bluntest answer might be 'we're ruling out cancer'. Research project after research project has shown that all a patient hears is 'Cancer', which isn't helpful, so the radiographer will avoid the C word, correctly supposing the Q&A session about the outcome of the test was a conversation you needed to have with your doctor, not with them. Yes, the reality is that cancer will be one thing they're ruling out! But that won't be all they can see and diagnose. BUT- and I'm really sorry if I'm turning your fear of radiation into fear of cancer, there are quiet a few people out there developing very late stage colonic cancers who're still at the 'increase my antacid' stage because they didn't or wouldn't undergo the tests that could have caught the problem early and at a curable stage.

Do the prep diligently, do your best at the pneumocolon to hang onto the gas (!) and it'll all be over in no time.

Bets of luck, but do get it done!

carmen66 Tue 09-Oct-12 10:15:14

Hi Littentree
Thankyou for your kind reassuring reply... Do you work in the medical field? Everything yo mentioned is very true I'm just not thinking rationally at the moment & I know that I have to go..

My appt is next Thursday & I am so nervous about the whole thing, I will have to fast 3 days prior to the procedure... When I spoke to my consultant last Friday she said that she felt 98% that it's nothing I'm not sure how to take this seeing as no other tests have been done apart from bloods that came back normal...
The diahorrea differs on a daily basis sometimes more formed I've had it for so long & I don't know any different now :-)

LittenTree Tue 09-Oct-12 10:52:51

The worst part about this test is the prep, it really is! It's more or less the same prep you'd have for a colonoscopy as they need to clear the bowel as much as possible to get a good look. A thought: get some nappy rash cream in. Apply it as soon as you start getting the 'effect' of the prep working, and slather it on!

As well as the prep you might be asked to drink some Xray dye stuff maybe a day before?

The test itself usually involves the insertion of a small flexible cannula into your arm through which they inject a bowel relaxant to help the bowel to distend with the gas as painlessly as possible (the injection can also give you fuzzy vision for 20 odd minutes as the muscle in your eye is the same type as that in your bowel wall!)- they won't give that if you have angina or glaucoma; and to inject xray dye at the time of the first CT scan as it outlines the blood vessels and organs and makes lots of grey-scale pictures more black and white thus easier to 'read'. It contains iodine- you'll be asked about allergies.

It isn't nice having anything put up your tail end but the tube is as thin as a woman's little finger. They usually inflate a small balloon on it once its inside you to stop it falling out as it will be well lubed! That might make you feel like you need to go to the loo as the balloon will sit on the same muscles that tell you you need to. It won't be 'desperate', though. They then run the gas in (carbon dioxide) using a special machine that controls the pressure. Once enough is in (you may get some gripy pain and internal 'bubbling') they'll do a quick, low does scan to check enough is in, the they'll run the xray dye through the cannula in your arm and do the CT scan itself. You hold your breath for each for about 7 seconds. The xray dye has 2 side effects- possibly an odd metallicy taste in your mouth and- the feeling like your wetting yourself down below! Ladies practically always get that feeling but it's just that, it's not real and it lasts about 20 seconds. Then they'll get you to roll onto your front and will repeat the CT scan- once they're happy there's enough inflation happening and the scans are technically good, you're unplugged, and it's all over. The vast majority of patients then exclaim 'is that it?!' as you get them a cuppa!

You may be asked to hold your breath 6 odd times for the scans. That's not 6 full loads of abdominal scan CT radiation. Usually, there are 2 'scout' or planning scans- a front and sideways one though you stay in the same position- per 'full' actual diagnostic CT scan. These planning scans are low does and low resolution. They are used to let the radiographers precisely plan where to begin and end the actual CT scan itself to get everything on (the whole large bowel) but nothing more than is necessary; so 2 planning scans plus 'The CT' on your back, ditto on your front.

Be aware the bowel prep may go on working after the scan for a few hours so take the same precautions for the rest of that day, and drink loads as the prep can dehydrate you and the injected xray dye puts a bit of a load on your kidneys.

As for cancer- as I said before, the vast majority of diagnostic tests carried out are one-offs i.e. someone presents to their GP with a set of symptoms that just might be cancer, usually a tiny percentage. So Test One will be just about always be 'Let's rule out cancer', which is done; cancer is just about always ruled out then the GP or specialist can set to work looking at other possibilities. This happens a lot with persistent coughs, rectal bleeding and persistent headaches. You're put on a 2 week wait waiting list that scares the bejeezus out of people BUT IF, IF it is The Big C you need a swift diagnosis so treatment can commence. The minute cancer is ruled out, you plummet down the waiting list designation, to 'Routine' grin! As an aside, patients do like to get angry that they were 'unnecessarily frightened' by the 2 week wait designation, then outraged at the subsequent 6 week 'routine' waits... hmm...

Can I finally say that the reality is, should you be unlucky enough to be in that tiny bowel cancer percentage, that the fear of the radiation of the diagnostic scans will seems trivial?!

Good luck!

carmen66 Tue 09-Oct-12 13:26:13

Hi, I don't know what the 2 week waiting list is after the CT scan? sorry maybe I have missed something also the relaxant that they use is frightening if it give's you blurry sight ... Thankyou for all the info have you had it done or are you in this line of work Littentree? :-)

carmen66 Tue 09-Oct-12 13:27:25

And also what is the designation waiting list to routine?

LittenTree Tue 09-Oct-12 17:08:00

The 2 week wait is a government imposed target. To be honest I'm not absolutely sure what time period it measures. I think it's the time that can elapse between a patient's referral/s for diagnostic test/s arriving in the relevant department/s and the test happening and being reported. Request forms arrive either pre-marked by the referrer as 2WW or CWT (Cancer Waiting Time) or the staff recognise that it should be and fast track it accordingly. It's for precisely the reasons I outlined: It's highly probably not cancer but if it is they need to get on top of it. There are I think 2 more levels of urgency below 2WW- I think the lowest one is possibly 16 or 18 weeks? I can check. These are for the sort of things like '5 year history of chronic sinus pain. Please scan sinuses'.

I guess it is perfectly possible for a pneumocolon to not be a 2WW, such as a long history of diahorrea (sp?) or to look at the progress of a long standing bowel condition, too.

As for the blurry vision, it's temporary and it's minor (you will be completely able to walk into the loo, then to your cubicle, then identify your accompanying mate after the scan). Of course, you don't have to have that injection but it does 2 things: your bowel wall muscle is a bit more relaxed thus can distend more easily and comfortably; and a distended bowel is easier to diagnose than a collapsed one!

Can I say, kindly, that you do appear to be looking for things to get scared about?!

carmen66 Tue 09-Oct-12 17:42:03

Omg I'm praying that it's not anything serious the consultant said that she's 98% sure that it's my anxiety but she was very understanding & said that properly to someone like me it properly doesn't account for much saying it..
I'm not thinking ratioanally although I am trying to prepare myself..

I did ask previously but is this your line of work? :-)

carmen66 Tue 09-Oct-12 17:43:01

probably sorry for spelling mistake

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