Having a CTC Scan with Picolax – Bowel Preparation and Diet Sheet

Please follow these instructions carefully to make sure that your bowel is as empty as possible and to improve the accuracy of this test.

You should have received some laxative (Picolax) and a 100ml bottle of Gastrograffin from the pharmacy. If not, please ring 01305 255397.

The Gastrograffin contains iodine. It is very important that if you are allergic to iodine or have previously had a severe allergic reaction to x-ray contrast dye, if you have difficulty in swallowing or if you suffer from regular choking/coughing episodes when drinking fluids, that you do not take it and phone the department on 01305 255397.

If you have diabetes, please seek advice from your diabetic team about how to manage the diet.

Four days before

Continue to take any prescribed medicine, but if you are taking iron tablets you should stop taking them.

Two days before

If you are taking any constipating medicines such as Codeine, Kaolin and Morphine, Loperamide (Imodium), Regulan or Fybogel, stop this two days before you are due to come for the examination. Continue other medications and any laxatives you usually take.

Start low residue diet – you may only eat what is listed below throughout the day.

Foods allowed on low residue diet

• White bread and bread products, such as crumpets, wraps and white naan
• Breakfast cereals, such as Cornflakes, Rice Crispies, Special K or Frosties with a small amount of semi skimmed or skimmed milk, rice milk or soya milk
• White pasta, white rice, couscous, tapioca, ground rice, semolina, peeled potatoes
• Quorn, tofu
• Chicken or turkey
• White fish
• Boiled, poached or scrambled eggs (without cream or butter)
• Boiled sweets, fruit gums, pastilles, Madeira cake, plain biscuits eg rich tea, water biscuits, cream crackers, rice pudding and plain sponge
• Strained stock, stock cubes, Marmite, Bovril, soy sauce, instant gravy
• Clear fluids including water, fruit squash, fruit juice with no bits, rehydration drinks, clear soup or broth, tea/coffee with small amount of milk
• Small amount of oil for cooking, honey, lemon curd, golden or maple syrup, marmite, smooth peanut butter and jams or marmalades with no bits
• Salt, sugar, fine ground pepper, vinegar, mustard, gelatine, dried herbs, salad cream, mayonnaise, ketchup.

Foods not allowed

• All fruit including dried fruit and vegetables
• Wholemeal, granary, brown and high fibre white breads and bread products (including best of both)
• Potato skins and chips
• Crisps and nuts, fresh herbs, pickles, chutney, hummus, freshly ground peppercorns
• Biscuits or cakes made with wholemeal flour/nuts/fruit/grains (fruit cake, Ryvita, digestives, hobnobs)
• Whole wheat pasta, bran and brown rice or noodles
• High fibre breakfast cereals such as Weetabix, Shredded wheat, bran flakes, porridge
• Red meat including burgers, sausages and ham
• Pulses such as beans and lentils
• Fried or fatty fish
• Full fat milk, cream, full fat yoghurt, ice cream and full fat hard cheese
• Butter and butter-like spreads, vegetable oils
• Drinks to avoid are full fat chocolate drinks, drinks with full fat milk, cocoa and vegetable juices.

One day before

Continue the low fibre breakfast before 8am. After this, you must only have clear fluids from now until after your CT colonography. You must not eat any food or have any fluids which are not clear during this period.

Clear fluids include the following:

• Water
• Black tea and black coffee (without milk), herbal or fruit tea (no solids)
• Clear, strained soups (consommé, sieved Minestrone)
• Oxo, Bovril or Marmite drinks
• Clear jellies
• Clear fruit squashes and cordials
• Clear fruit juice (such as apple or grape)
• Boiled sweets
• Clear, fizzy drinks can be drunk but can make you feel bloated.

At 8am take the first sachet of Picolax. Prepare the Picolax by mixing the contents of one sachet in a cup of cold water (approximately 150ml) and stirring for two to three minutes. The solution may become hot. Wait until it has cooled down before drinking. You can flavour it with a clear squash or cordial if you do not like the taste. Some people find it easier to drink it through a straw.

Drink 30mls Gastrograffin mixed with water/clear squash.

Continue to drink plenty of clear fluids (aim for one or two glasses an hour).

After two to three hours you should start to experience frequent bowel motions followed by diarrhoea. This will mean that you will need easy access to the bathroom. Some abdominal cramping is expected.

Advice regarding medication can be found within the information booklet. Please avoid taking medication within an hour of taking Picolax.

At 4pm take the second sachet of Picolax and 30mls Gastrograffin. Remember to keep drinking plenty of clear fluids for the rest of the day. You will find that your stool (poo) becomes more liquid and clearer each time you open your bowels. By the morning it should be watery and fairly clear.

On the day of the scan, you can have clear fluids up to the time of the scan, but no solid food. After the scan you can eat and drink as normal and you may want to bring a snack with you to have in the department before going home