Introduction
We hope this guide will answer your questions about your water-soluble contrast enema
– colostomy/ileostomy examination. Please contact the team if you require further information via the details at the end of this leaflet.
What is a water-soluble contrast enema
– colostomy/ileostomy examination?
This is an examination to look at the section of bowel leading to or from your stoma (opening onto the abdominal wall) using X-rays and a contrast medium (a clear iodine based solution often known as X-ray dye). Normally, your bowel does not show well on X ray on its own. The contrast medium can be seen on X-rays and is used to fill and coat the bowel, making it visible. A small tube (catheter) is inserted into your stoma then the contrast medium is passed through this into the bowel. The test is carried out by a radiologist (a doctor who uses x-ray to diagnose and treat conditions), and a radiographer (a health care professional that helps facilitate the x-ray images safely). Sometimes, an assistant or a student radiographer may also be present.
What are the alternatives?
Currently, this study has been considered as the most appropriate test for you or may be part of a range of examinations needed to get a diagnosis.
Why do I need a water-Soluble contrast meal and follow through Examination?
Your doctor should have explained the reason why you need this test. It is usually a follow-up examination to check if your bowel has healed after a previous operation, or before an operation to close a stoma.
What are the risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor has determined that the benefits of having the water-soluble enema outweigh potential risks. The radiographer is present throughout your test, making sure that the dose is kept as low as reasonably possible and the duration and level of X-rays are kept to a minimum.
Perforation: Having an enema examination means an amount of contrast medium is introduced into the bowel through a catheter. During this process, however unlikely, there is the possibility of making a small hole in your bowel, known as a perforation. This happens very rarely and generally is a risk only if there is a problem like severe inflammation of the bowel wall.
Contrast: Very rarely, you may have an allergic reaction to the iodine contrast medium, if this occurs it will be treated by the team looking after you. At any point during or after the examination, if you develop itching or difficulty breathing, tell your radiographer or doctor immediately.
Patients aged 12 to 55, could you be pregnant? X-rays can be harmful to an unborn
baby and should be avoided by patients who are or may be pregnant. It is recommended that the examination is performed within 10 days of the first day of your menstrual period. If your appointment is not within this time or if you think you may be pregnant, please contact the X-ray department before your appointment. When you arrive for your test, you will be asked when your last period started. If it is more than 10 days earlier, your appointment may be postponed.
Will I need an injection?
Occasionally, patients are given a small injection of hyoscine butylbromide (Buscopan) in the arm to help relax the muscles of the stomach. After this injection, you may experience some dryness of your mouth and blurred vision. This will disappear after a few minutes and cause no ill effect.
Preparing for your procedure
No preparation is required for this examination. You may continue to eat and drink as you normally would. If this changes you will be advised appropriately beforehand. If you have a stoma (opening onto the surface of the abdomen) please bring a spare stoma bag with you just in case it is needed after the examination. If you are unsure or have questions about your preparation contact your doctor or the X-ray department for advice. Please contact the booking team before your appointment if:
- you plan to use hospital transport or require a hoist transfer
- you are or think you may be pregnant
- you are an insulin dependent diabetic
- you have glaucoma
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Please contact the booking team in advance if you plan to use hospital transport or
require a hoist transfer.
Allergies
If you have asthma or any allergies, especially to iodine or contrast medium (X-ray dye),
please inform us in advance.
Medication
Please continue to take all medications unless you have been advised otherwise.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse and radiographer, a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes or other medical conditions, such as thyroid disease and diabetes you may have. Before the procedure, the interventional radiologist will explain the procedure and ask you to complete a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. You will need to lie on the X-ray table where a small, soft plastic tube will be placed either into your back passage or your stoma, depending on the information your referring doctor requires. A small amount of contrast medium will then be introduced into the bowel. During the procedure you may be asked to hold in as much fluid in your bowel as possible. It is not uncommon for contrast medium to leak during the procedure; please do not be concerned if this happens but let us know. You may be asked to lie in various positions to enable the passage of contrast medium to the area of interest. At the end of the examination we will drain out as much of the contrast medium as we are able to. Despite best efforts some contrast medium will remain in your bowel and over time will pass either into your stoma bag or into the back passage. This can take up to 12 hours. Whilst the contrast medium is in your system you may experience some loose motions this is normal. Your radiographer and radiologist will be with you the whole time during the procedure and will explain what is happening or what you need to do on the day. If you have any questions or concerns, it is OK to ask.
How long will this take?
This examination can take up to 45 minutes, you should expect to be in the department for up to an hour.
Is it uncomfortable?
This procedure is not painful but it can be uncomfortable and unpleasant.
After the procedure
The examination should not be painful. Some people may feel bloated after their enema examination. However, most people have few if any side effects. To help clear the remaining contrast in your bowel drink plenty of clear fluids to flush it through your system. At the end of the test, you will be able to go home immediately or when you feel ready. You can eat or drink normally and take your normal medications.
Can I drive after my procedure?
You are able to return to work as soon as discharged from the department.
How soon can I return to work?
You are able to return to work as soon as discharged from the department.
When will I get my results?
You will not know the results of your examination immediately. The radiologist will report their findings to the clinician who arranged your procedure, who will discuss the results with you. It may take a couple of weeks for the results to become available.
Contacting the team
- If you have any further questions about your CT scan or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 827179. Press option 1 for radiology appointments, then option 4.
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.