Preparing for a Bronchoscopy

Informed Consent: As a patient, you have the right to understand your health and lung condition in words that you understand. You have the right to plan your medical care, including whether you need a bronchoscopy; you always have the right to refuse a procedure. To help with your planning, you must learn about your health and lung condition and how it may be treated or diagnosed. To that end, you should work with your lung physician (pulmonologist) to understand what tests, treatments, or procedures may be used to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You will be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. Before giving your consent, though, make sure all your questions have been answered.

History and Physical: A thorough medical history and physical examination should be performed prior to a bronchoscopy. A specific history of bleeding or clotting (coagulation) disorders, irregular heart rhythms (arrhythmias), reactive airways disease (asthma), hypoxemia (low oxygen), hypercarbia (high carbon dioxide) and allergies (environmental, drug, latex and tape) should be obtained and recorded. Additional Testing: You may need to have new or repeat radiographic imaging of your chest prior to the bronchoscopy, such as a chest x-ray or chest CT scan. You may need other heart, electrocardiogram (ECG), and lung tests (pulmonary function tests, PFTs) prior to a bronchoscopy. You may need to have additional blood drawn for tests, such as a complete blood count, arterial blood gas (ABG), and clotting tests. These additional chest imaging, heart, lung, and blood tests will provide your pulmonologist with more information regarding the location of your lung abnormality and your general health condition. That information will determine your ability to safely tolerate a bronchoscopy. Pre-Bronchoscopy Instructions: If you are having a bronchoscopy as an outpatient or as a noncritically ill inpatient, you will be instructed not to eat for 6 to 8 hours before the procedure. This helps decrease the risk of vomiting during a bronchoscopy. You will also receive instructions about taking your regular medicines, smoking cessation, and removing any dentures or partial dental plates before the bronchoscopy. Patients who have diabetes mellitus may need to follow special instructions about their diet and medications (insulin and diabetic pills). Medicines that you may need to stop taking before your bronchoscopy include aspirin, ibuprofen, or prescription blood thinners. Post Bronchoscopy Discharge Planning: If you are having your bronchoscopy as an outpatient or you are to be discharged from the hospital after your bronchoscopy, arrangements must be made for a family member or friend to drive you home after the bronchoscopy. Because you may receive sedative (calming) and analgesic (pain relieving) medications you should not operate a motor vehicle.

Prior to a Bronchoscopy (Pre-Operative Care)

and make you drowsy while your vital signs are continuously monitored. a combination of anti-anxiety medications (i. which anesthetizes (numbs) the nose and the posterior throat area to prevent coughing and gagging during the procedure. Conscious Sedation: If the bronchoscopist determines that a patient is an appropriate candidate for conscious sedation. during. Usually the lights in the procedure room are dimmed during the procedure to enhance the viewing of the bronchoscopy video screen or fluoroscopy (x-ray) screen which is used for biopsies. blood pressure and oxygen saturation will be documented prior to the bronchoscopy procedure.Checking In: If you are an outpatient. Conscious sedation may also help you forget any unpleasant sensations experienced during the bronchoscopy. Intraoperative Monitoring: You will be connected to a monitor for continuous electrocardiogram (ECG) to monitor your heart rate and rhythm. The use of intravenous benzodiazepines and/or narcotics for conscious sedation. sedative and analgesic medications during the procedure.. Caregivers will have you remove your glasses. blood pressure. oxygenation or cooperation are controversial. Patients who are unable to hold still during a bronchoscopy may require general anesthesia.. respiratory rate. benzodiazepines) and analgesic medications (i. you will be completely asleep during your bronchoscopy. respiratory rate. and after the bronchoscopy. or partial dental plates.e. you will inhale an aerosol spray of a numbing medication (i. Intravenous Access: An intravenous (IV) line will be placed in your vein for the administration of intravenous fluids. narcotics) will be administered intravenously. These intravenous medications will help you to relax. Your informed consent for the bronchoscopy will be obtained and/or confirmed prior to the procedure. You will be asked to change into a hospital gown. relieve your anxiety. looking up) with the head of the procedure bed tilted slightly upward. lidocaine). and go to the bathroom before the procedure so that you will be comfortable.e. the bronchoscopist will be able to explain what is happening step-by-step. You will be lying down in a supine position (on your back. dentures. Patient Preparation Prior to Bronchoscopy Local Anesthesia: Before beginning a bronchoscopy. Vital Signs: Your temperature. Many side effects of bronchoscopy are secondary to the side effects and combination use of these medications. You may also need general anesthesia when having some bronchoscopy procedures. and cough suppression without impairment of ventilation (breathing). Flexible Fiberoptic Bronchoscopy Procedure .e.. such as removing foreign objects ± and will need general anesthesia for a rigid bronchoscopy. If you have general anesthesia. Patient Positioning: If you are awake (conscious) during the procedure. you will be instructed to check into the pre-operative area. This is to monitor your vital signs and condition before. heart rate. and blood oxygenation during the bronchoscopy procedure. It is important for you to hold still during the bronchoscopy.

and pulse oximetry (oxygen saturation). the reason for the procedure. position. All the carinae (branching points) and segmental bronchial orifices (airway openings) of the tracheobronchial tree are directly visualized on the bronchoscopy video screen. All patients receive supplemental oxygen during and after the procedure.Routine intraoperative monitoring during a bronchoscopy includes continuous heart rate. however. After insertion into the trachea. and/or the type or number of samples to be obtained. the FOB is advanced to the carina. depending on how long it takes for patient preparation. heart rhythm (electrocardiogram). Specimens are collected using a variety of techniques. You may feel like you cannot ³catch your breath. respiratory rate. The flexibility of the FOB allows the bronchoscope to pass through the nose or oral route into the posterior throat to a position above the vocal cords. the transoral approach is reserved for patients with bleeding disorders or obstructive nasal anatomy. The transnasal route provides the greatest patient comfort. and malignant diseases of the chest. It should be performed by an experienced bronchoscopist in an operating room. Once the FOB passes through the vocal cords you will not be able to talk. Rigid Bronchoscopy Procedure Rigid bronchoscopy is typically performed with the patient under general anesthesia. texture. color. . The vocal cords are numbed and the FOB is advanced through the vocal cords into the trachea (windpipe). The bronchial mucosa (airway lining) is also inspected for the presence of infiltration.´ but there is enough room to breathe and receive oxygen. Fiberoptic Bronchoscopy Specimens and Diagnostic Yield Fiberoptic bronchoscopy provides lung specimens for microbiological. and histological (under the microscope) analysis in order to evaluate for infectious. Transnasal (thru the nose) and transoral (thru the mouth) routes may be used in non-endotracheal tube intubated patients. To help relieve this feeling. and secretions. cytological. your vital signs are continuously monitored and your anxiety is relieved with an intravenous combination of anti-anxiety medications (benzodiazepines) and analgesic (pain) medications (narcotics). Each carina of all the sub-segments of the lung are examined for sharpness. the intraoperative medications to take effect. mechanically ventilated patients require passage through the endotracheal tube. inflammation. As noted above. which divides the trachea into the left and right mainstem bronchi (left and right lung airways). blood pressure. size and patency. This allows the bronchoscopist the ability to examine the inside of the lungs through the mini-camera at the bronchoscope¶s distal illuminated tip. you may be instructed to swallow or take deep breaths. inflammatory. The bronchoscopy could take anywhere from 30 minutes to an hour. During this time your airway passages will be numbed with an anesthetic. Three approaches are available for passage of a flexible fiberoptic bronchoscope. The FOB is then advanced through the mainstem bronchi into the smaller segmental and subsegmental airways of both the left and right lung.

The risk of major complications is highest in those with active ischemic heart disease and advanced pulmonary disease. The discussion of these multimodality bronchoscopic techniques is beyond the scope of this article. hypoxemia. fever and. Risk and Complications of Rigid Bronchoscopy . the yield for peripheral lesions less than 2 cm in diameter is as low as 20% (range 23-58%) (10). and respiratory failure. Major complications have been reported in 0. with a mortality of 0. pulmonary hemorrhage. Yield for non-bronchoscopically visible peripheral lung lesions greater than 3 cm in diameter is greater than 80% (range 44-85%) (10). the ability to obtain a diagnosis) is influenced by specimen size. However. and endobronchial or transbronchial needle aspiration (TBNA). which can make the histological pattern recognition difficult. The addition of washings. cardiac dysrhythmias. The diagnostic yield for endoscopic visible lesions when using a variety of sampling techniques is approximately 70-95% (9). endobronchial ultrasound (EBUS). The yield of TBNA in evaluating mediastinal nodes in patients with lung cancer is 10-50% and depends on detection of mediastinal lymphadenopathy by chest computed tomography (CT) scanning. Other complications include conscious sedationinduced hypoventilation. Diagnostic yield (i. The advantages of the procedure are that the central lumen of the instrument provides access for a variety of instruments while maintaining maximal central airway patency (clearance).5% (14).11). bacteremia (bacteria in the blood). disease distribution. cardiac ischemia. and TBNA increases the yield to approximately 60% (10. Risks and Complications of Fiberoptic Bronchoscopy Fiberoptic bronchoscopy is safe in the hands of experienced operators. endobronchial or transbronchial biopsy (TBBx).including bronchial washing. brushings.11) Additional techniques such as autofluorescent bronchoscopy have increased the detection of premalignant and malignant lung cancers (12). and electromagnetic navigational bronchoscopy (ENB) have improved the yield of flexible bronchoscopy in the diagnosis of peripheral lung lesions without compromising safety of the bronchoscopy (13). The diagnostic yield of transbronchial procedures for peripheral (distal) nodules depends on the size of the lesion and the number of specimens obtained. bronchoalveolar lavage (BAL). bronchial brushing. Rigid Bronchoscopy Diagnostic Yield Rigid bronchoscopy is primarily a therapeutic modality and is rarely used for diagnostic purposes. bronchospasm. specimen number. Major complications include pneumothorax (punctured and collapsed lung).08-5% of procedures. whereas.01-0. rarely. and biopsy specimen crush artifact (tissue distortion as a result of the sampling procedure). (10. BAL.e.

Limitations of rigid bronchoscopy include inability to evaluate distal airways or to perform it on mechanically ventilated patients. Take throat lozenges or gargle with salt water if your throat is sore and drink liquids to help decrease dryness in your mouth or throat. If you are allowed to go home after your bronchoscopy. someone else must drive. the patient is assessed for respiratory difficulty (stridor and dyspnea (shortness of breath) resulting from laryngeal edema or laryngospasm). Call Your Doctor . Monitoring continues until the effects of sedative medications wane and the patient¶s gag reflex returns. your caregiver may tell you not to cough forcefully or clear your throat. physicians require that the patient remain under a brief period of observation. obtaining vital signs every 15 minutes for the first hour. a sore or scratchy throat. This is to keep the biopsy site in the lung from bleeding. Recovery room nurses watch closely for two to four hours following the procedure. This is to keep the biopsy site in the lung from bleeding. In addition. you may feel sick to your stomach (nausea) and may throw up (vomit). or may have a dry mouth. You also may be tired for a day or two after the procedure. or skull injuries may be aggravated due to manipulation during the procedure. You may try eating food after you can drink without choking or getting sick (nausea). do not cough forcefully or clear your throat for a day or two. If you had a biopsy. During the recovery period. Remember that you may feel dizzy or light-headed as you wake up. he or she will have a chest x-ray to rule out any air leakage in the lungs (pneumothorax) after the procedure. You may be tired for a day or two after your bronchoscopy. or a low grade fever (101oF). If you had general anesthesia. air leakage (pneumothorax). mandible. Do not drive or do anything that requires your full attention for at least 12 to 24 hours. cervical spine. Most complications occur early and are readily apparent at the time of the procedure. If you had a biopsy. If the patient has had a transbronchial biopsy. or respiratory distress. Do not try to stand until your caregiver says it is okay to do so. The patient will be hospitalized if there is any bleeding.The major risks of this procedure are those associated with general anesthesia. Activity and Home Care Do not eat or drink anything until the numbing medicine in your throat has worn off. Post Bronchoscopy Recovery Although most patients tolerate bronchoscopy well. and then every 30 minutes for the second hour while the patient is kept in the semi-fowler or upright position. Rest when you feel it is needed. You can usually begin drinking sips of water about two to four hours after the procedure. Your throat may feel scratchy for a few days after the bronchoscopy. You may also have a low grade fever after your bronchoscopy.

and colon cancer. . polyps. You have bleeding from your nose that cannot be stopped after 10 minutes. It also helps the radiologist see the size and shape of the colon and rectum. which includes the colon and rectum. uses x-rays to diagnose problems in the large intestine. You may be uncomfortable during the barium enema. that rarely happens because the tube used to inject the barium has a balloon on the end of it that prevents the liquid from coming back out. show up more clearly on x-rays. The barium will cause fullness and pressure in your abdomen and will make you feel the urge to have a bowel movement. ulcers. The barium coats the lining of the colon and rectum and makes these organs. also called a lower gastrointestinal (GI) series. and any signs of disease in them.Call your doctor if you have any of the following symptoms: Shortness of breath A temperature above 101oF for more than 24 hours. However. If you have chest pain or severe shortness of breath. barium enema What is a barium enema? A barium enema. Seek medical care immediately if: You have chest pain or discomfort. Bleeding from your nose or throat. diverticuli. You have new or worsening trouble breathing. What happens during a barium enema? Before taking x-rays of your colon and rectum. the radiologist will put a thick liquid called barium into your colon via an enema. The barium enema may show problems like abnormal growths.

You may be asked to change positions while x-rays are taken. The radiologist may also take an x-ray of the empty colon afterwards. Apart from that. barium enema experiences IMPORTANT NOTE: Although some people find these tests uncomfortable and occasionally painful. I had an injection of Buscopan roughly half-way through the procedure. with the exception of the intestinal cramps which can occur with the introduction of air into the colon. The experience was a painless one. .. You should also make sure you follow your doctor's preparation instructions carefully. it's a doddle. What results will I have if I am suffering from IBS? There will be no visible signs of abnormalities if you are suffering from IBS. To prepare. The tale of. How do you prepare for a barium enema? Your colon must be empty for a barium enema to be accurate. I had Picolax and I think the effects of this stuff being described as 'vigorous' are an understatement. Your physician may give you other special instructions. There is a certain amount of discomfort and nothing to cause concern. fresh from the hospital and just having had an enema at 9. Different positions give different views of the colon. the doctors have seen it all and there really is nothing to be embarrassed about. To make sure your colon is empty. only clear liquids the day before. After the radiologist is finished taking x-rays. and nothing after midnight the night before. The barium may cause constipation and make your stool turn gray or white for a few days after the procedure. they are vital diagnostic tools.30 this morning.. By far the worst of the procedure is in the prep the day before. If you are referred for this procedure. you might be able to drink only liquids and eat only non-sugar. again.Peter Hello. If you are worried about embarrassment. you will be given a laxative or an enema before the procedure. non-dairy foods for two days before the procedure. and afterward was able to drive home myself. A barium enema takes about one to two hours. I would always recommend having any and all of these tests if they are recommended by your doctor. don't worry. all is well and I'm a happy bunny again. you will have to restrict your diet for a few days beforehand. For example. here I am. Just relax and all will be well. you will be able to go to the bathroom.

castor oil is bad . Plus when you think that little bit of uncomfortable-ness can save your life.the prep is the worst part (good Lord.I did spend most of the day on the toilet. and the exam itself is ridiculously uncomfortable but it's over quickly. The exam took about an hour and then I could go home. .Barbara I agree with everyone on this page . The enema and x-ray procedure itself is OK providing you can manage to relax. As for going to the bathroom when the procedure is finished . and the rest of it went quite well with the odd bit of humor thrown in from the nurse. The tech that I had was great. I'm going to have to tell them to stop'. I took the advice I was given by the hospital and bought some vaseline which was very useful. and even managed to sleep most of the's worth it! Good luck! The tale of.I felt like I was on Fear Factor). and it did make me quite weak and very hungry. The pain from the wind was barely manageable.again no problem. so all in all I am really pleased I wasn't silly enough not to turn up. The Picolax laxative is powerful stuff and kicked in within about 30 minutes of taking it (drink loads of fluids). It's an odd sensation as the barium mixture is poured inside you. The exam wasn't too bad.. just a bit uncomfortable. The tale of. The effects of the Picolax seem to wear off pretty quickly.. which did help the situation..Geoff I had my first experience of a barium enema last week. at no point was I uncomfortable. I can't believe I was actually laughing during my exam. but it only lasted an hour and started to go. So that's another thing to add to my list of things I didn't want to do in life but weren't as bad as I thought. because she explained everything and her sweetness made me relax even more. but not one which I would describe as uncomfortable.The tale of. Having said that. and I have to say that the whole thing was remarkably OK. The Picolax is powerful stuff .. and at one point near the beginning I thought 'I can't do this. but I just did deep breathing and tried to relax. whilst I had to make frequent visits to the toilet.. The most discomfort I had was having to spend 30 minutes lying on the hard. Just relax and you will be fine... I actually struggled to go at all in the hospital and it was only several hours later at home that I actually passed most of the barium. uncushioned x-ray table.Marianne I had my barium enema last week and it wasn't that bad.

Normally you take two but I took three as I thought two did not flush my bowel out enough. The tale of. Drink plenty of water if you are given Picolax laxative. but thank goodness with some muscle control you are able to hold it until the x-rays are done. The next day I was weak. Just pace yourself drinking the crud the night before.. The night prior was horrible.. The tale of. That was when the doctor showed me the results immediately on the video screen ... Honest! . After the test was done.Jay I would echo what others say on this page.I felt well enough to sit there and converse with him/ask questions while everything was still in me. I sat there for like 10 minutes with the barium still in me and felt fine.All in all.. When the barium flows in I would describe it as a very mild cramping/bubbling sensation. By far the worst part for me was drinking the stuff the night before. etc. relax and it will be OK. it's not particularly uncomfortable and certainly not something to fear. and felt like jello. don't sweat it. I pretty will slept in the bathroom after taking the laxatives. The exam itself only lasted like 15 minutes with about 10 minutes before and after for preparation. The actual test is fine. Not as bad as I thought. I ran to have a bagel with coffee right after the test and vomited within half an hour. The test itself was not as bad as I had anticipated and the radiologist added some humor in order to alleviate the discomfort. I was nauseous for the rest of the day and slept the entire afternoon. The test itself was not nearly as bad as I thought.Lee I went for my test yesterday! The worst of it all was the prep for it. It simply feels like you're going to have the biggest explosion.Pauline The worst part is definitely the prep. Uncomfortable at certain points (insertion of enema) but not painful at all. so go easy on the stomach once you've done your test.. The tale of. The fasting made me light-headed and gave me a headache. nauseous. whilst it's not a pleasant procedure. So if you're preparing to have one of these.

it just has an uncomfortable feeling. once the exam is over you will be glad to go to the bathroom. The contrast dye allows for better visualization of gallstones and other abnormalities of the gallbladder that cannot be seen on a standard x-ray of the abdomen. A contrast dye is swallowed prior to the procedure. It can be very difficult to always run back and forth to the bathroom and some of the physical things you must do to prepare are not very great either.A I am younger than 16 years of age and have had a barium enema. X-rays of the Gallbladder) Procedure Overview What is cholecystography? Cholecystography is an x-ray procedure used to examine the gallbladder when gallstones are suspected. You will feel uncomfortable during the exam because there is a bit of pressure and you feel as though you need to use the bathroom immediately. GB Series. . For everyone concerned with going through a barium enema. and other internal structures for diagnostic purposes... its organs. A barium enema does not take very long at all. the whiter it appears on the film). X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is. bones. Therefore. try to relax. During prep I began to get dehydrated because I was losing so much liquid. The worst part of it all is the 24 hour prep. and this resulted in vomiting and nausea. If you co-operate and relax and turn when the doctor tells you to turn.The tale of. There is no reason to fear the exam itself because it does not hurt. This is all normal and trust me. X-rays are made by using external radiation to produce images of the body. it is very important to remain hydrated at all times. Oral Cholecystogram. Oral Cholecystography. and remember to relax! holecystography (Gallbladder Series. and organs on film. X-rays use invisible electromagnetic energy beams to produce images of internal tissues. Good luck. everything will go well and quickly. such as the bag enema.

Bile ducts can also be obstructed by cancer or trauma. or when they begin obstructing bile ducts. What are gallstones? Click Image to Enlarge Gallstones form when bile stored in the gallbladder hardens into stone-like material. bile salts. Attacks of gallstones usually occur after a fatty meal and at night. Too much cholesterol. when gallstones become larger. and gallbladder nuclear scans. However. Ultrasound and computed tomography (CT scans) are faster and often more accurate in diagnosing conditions of the gallbladder. Eighty percent of gallstones are cholesterol stones. CT scan of the liver and biliary tract. Symptoms may include. When gallstones are present in the gallbladder itself. most gallstones do not cause symptoms. it is called choledocholithiasis. What are the symptoms of gallstones? At first. pancreas. it is called cholelithiasis. Depending on how well the contrast dye has been absorbed. The following are the most common symptoms of gallstones. but are not limited to. Slow emptying of the gallbladder can also contribute to the formation of gallstones. cholecystography is no longer performed routinely.Contrast dye. When gallstones are present in the bile ducts. each individual may experience symptoms differently. symptoms or "attacks" begin to occur. A person can develop a single stone or several stones. Other related procedures that may be used to diagnose problems of the gallbladder include abdominal x-rays. The size of gallstones varies from a grain of salt to golf-ball size. or liver. or bilirubin (bile pigment) can cause gallstones. endoscopic retrograde cholangiopancreatography (ERCP). when swallowed prior to the cholecystogram. causes the gallbladder to appear opaque on a cholecystogram x-ray film. polyps and tumors may also be visible on the x-ray film. However. There are two types of gallstones: cholesterol stones and pigment stones. abdominal ultrasound. Gallstones will appear as dark spots within the gallbladder or bile ducts. Please see these procedures for additional information. Gallstones that obstruct bile ducts can lead to severe or life-threatening infection of the bile ducts. the following: . Due to the development of improved technology.

Patients with kidney failure or other kidney problems should notify their physician. Always consult your physician for a diagnosis. In addition to gallstones and obstruction of the bile ducts. inflammation. you should notify your physician. and intolerance of fat in the diet are present. as impaired liver function decreases the usefulness of the contrast dye. and nonfunctioning gallbladder. infection. There may be other reasons for your physician to recommend cholecystography. polyps. Radiation exposure during pregnancy may lead to birth defects. contrast dye. and indigestion The symptoms of gallstones may resemble other medical conditions or problems. If contrast dye is used. tumors. If you are pregnant or suspect that you may be pregnant. Patients who are allergic to or sensitive to medications. Risks of the Procedure You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. Reasons for the Procedure Cholecystography may be performed when signs and symptoms of gallbladder disease. In some cases. so that you can inform your physician. Patients with liver disease or other liver damage should notify their physician. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time. or iodine should notify their physician. especially if the person is taking Glucophage (a diabetic medication).yellowing of the skin and eyes abdominal bloating intolerance of fatty foods belching or gas. but are not limited to.y y y y y y y pain that comes and goes in the abdomen nausea and/or vomiting fever and/or chills jaundice . jaundice. such as right upper quadrant abdominal pain. It is a good idea to keep a record of your past history of radiation exposure. such as previous scans and other types of x-rays. the contrast dye can cause kidney failure. other conditions that may be detected by cholecystography include. These symptoms may indicate the presence of gallstones or other obstructions in the gallbladder and/or bile ducts. . there is a risk for allergic reaction to the dye.

During the Procedure Cholecystography may be performed on an outpatient basis or as part of your stay in a hospital. you will be given a gown to wear. or gallbladder inflammation barium within the intestines due to a recent barium x-ray procedure Before the Procedure y y y y y y y y y Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure. It is very important that you follow the instructions exactly as given in order to obtain adequate contrast visualization of the gallbladder. You will be asked to remove any clothing or jewelry that may interfere with the exposure of the body area to be examined. . If you are asked to remove clothing. Notify the radiologic technologist if you have any vomiting or diarrhea after taking the contrast dye. vomiting and/or diarrhea after swallowing the dye. Notify the radiologic technologist if you are pregnant or suspect you may be pregnant. Procedures may vary depending on your condition and your physician's practices. Your physician will give you instructions regarding fasting prior to the procedure. latex. Based upon your medical condition. Generally. Generally.There may be other risks depending upon your specific medical condition. You may also be instructed to withhold cigarettes and chewing gum as well. You will be asked to sign a consent form that gives permission to do the procedure. your physician may request other specific preparation. Notify your physician if you are sensitive to or are allergic to any medications. Your physician will give you the contrast dye (tablets taken by mouth one at a time) to swallow the night before the procedure. Be sure to discuss any concerns with your physician prior to the procedure. These factors include. or if you are allergic to iodine. and anesthetic agents (local and general). 2. Certain factors or conditions may interfere with the results of the test. Read the form carefully and ask questions if something is not clear. the following: y y inadequate absorption of the contrast dye due to liver disease or damage. then withhold food and liquids after midnight. tape. Notify the radiologic technologist if you have ever had a reaction to any contrast dye. intestinal malabsorption. but are not limited to. cholecystography follows this process: 1. because the procedure may have to be rescheduled if too much contrast dye was lost. you will be instructed to eat a fat-free meal the night before the procedure.

you will be given some type of fatty intake to stimulate gallbladder contraction. depending on your particular situation. or you may be given a fatty synthetic substance either by mouth or by intravenous (IV) injection. The radiologist will look at the x-ray films before you leave to ensure that the gallbladder was adequately visualized during the procedure. depending on the x-ray view your physician has requested. If the x-rays are inadequate. 11. Additional x-rays will be taken after you have consumed the fatty intake.3. the radiologic technologist will ask you to hold still for a few moments while the x-ray exposure is made. 5. You may be given a fatty meal. Several x-rays will be taken while you are in various positions. You may be given an enema prior to the procedure to clear the intestines of gas or feces that may interfere with imaging of the gallbladder. Once you are positioned. 4. 8. 9. The x-ray beam will be focused on the area to be photographed. or to lie on your side on a table. It is extremely important to remain completely still while the exposure is made. Body parts not being imaged may be covered with a lead apron (shield) to avoid exposure to the x-rays. The radiologic technologist will step behind a protective window while the image is taken. You may have x-rays taken from more than one position. However. your physician may give you additional or alternate instructions after the procedure. Because the contrast dye is excreted from the body through the kidneys. 10. there is no special type of care following cholecystography. to lie flat on a table. 7. the test may need to be repeated. If testing of the gallbladder's ability to contract is requested. as any movement may distort the image and even require another x-ray to be done to obtain a clear image of the body part in question. After the Procedure Generally. . You will be positioned in a manner that carefully places the part of the abdomen that is to be x-rayed between the x-ray machine and a cassette containing the x-ray film. You may be asked to stand erect. 6. you may feel some slight discomfort with urination for a day or so.

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