Water Soluble Contrast Swallow and meal Examination Patient information leaflet - The Princess Alexandra Hospital NHS Trust

Water Soluble Contrast Swallow and meal Examination Patient information leaflet (206kB pdf)

Introduction

We hope this guide will answer your questions about your water-soluble contrast swallow
and meal 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 swallow and meal examination?

A water-soluble contrast swallow and meal is an examination to investigate your gullet (oesophagus) and stomach and duodenum (the part of your intestinal tract that passes from your stomach to your small intestine) using X-rays and a contrast medium (an iodine based solution often known as X-ray dye). Normally, your intestinal tract does not show well on X-ray on its own. The contrast can be seen on X-rays and is used to fill and coat the stomach, making it visible. It can help to find out why you are having difficulty with swallowing. A water-soluble contrast swallow uses an iodine solution that contains contrast that you will be required to drink. A radiologist (a doctor who interprets images to make a diagnosis) and a radiographer (a healthcare professional that helps facilitate the x-ray images safely) carry out the test. Sometimes, an assistant or a student radiographer may also be present.

What are the alternatives?

The main alternative diagnostic test to a water-soluble contrast swallow and meal is a gastroscopy (also called an endoscopy). This test looks inside your oesophagus, stomach and the first part of your small intestine. It involves using a narrow, flexible, tube-like telescopic camera called a gastroscope to look inside, each examination has their specific advantages and drawbacks. 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. If you have any questions regarding what is the most fitting test for you, please speak to your referring clinical doctor to explain to you the available options.

Why do I need a contrast swallow and meal examination?

Your clinical doctor has referred you for a Water-soluble contrast swallow and meal examination to help make a diagnosis or to guide further treatment plans. This examination is performed to show the structure of your upper intestinal tract or because you have problems swallowing. It is also performed as a follow-up examination after you have had a recent operation involving your oesophagus and/or stomach, to check that you have healed inside fully before you start to eat solid food. Your radiographer or radiologist will discuss the procedure and your symptoms as well as any concerns you may have with you. If you don’t want to you can opt not to go ahead with the Water-soluble contrast swallow and meal examination and we will write to your referring doctor to let them know.

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.

Contrast: Almost all of the contrast (and air, if used) is drained at the end of your examination, with the remaining mostly passed after you visit the toilet. However, if you have a stoma, some of the contrast may collect in the bag, and you might need to change it. Once all the liquid has been passed, there should be no after effects following this procedure other than your bowel movements possibly being loose over the next few hours. There is a small possibility that you 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.

Aspiration? There is a small risk of inhaling small amounts of liquid, if this occurs you will
be assessed and treated as necessary.

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.

Breastfeeding: If you are breast feeding please inform the department before your appointment, you may need to postpone your appointment or express some breast milk prior to your appointment.

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

Please have nothing to eat and drink for six hours before your appointment time. Leave jewellery and valuables at home. 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
you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you

If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.

Allergies

If you have asthma or any allergies, especially to iodine or contrast medium (X-ray dye), please inform us in advance.

Medication

Please do not take any medication that requires food until after your examination, you can still take medication that can be taken with water.

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. At the beginning of the examination you will be given a fizzy drink and a contrast solution. This is to make your stomach visible on the X-rays. The radiologist (doctor) will then take several X-rays with you standing up and lying down on the X-ray couch which may move or tilt too, whilst looking at your digestive system on the x-ray monitor. 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.

Is it uncomfortable?

This procedure is not painful but it can be uncomfortable and unpleasant.

After the procedure

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?