CT enema scan - Overview - Preparation with sodium picosulphate and barium (E-Z-CAT) | Guy's and St Thomas' NHS Foundation Trust

Important - only follow these instructions if:

you are taking sodium picosulphate and barium (E-Z-CAT) as preparation before your scan.

You have been asked to take a laxative preparation (sodium picosulphate) and a liquid dye called barium (E-Z-CAT).

You have been asked to take barium because you have an allergy to iodine, which is used in other preparation methods for a CT enema scan.

These will help to empty your bowel, and 'tags' poo that is left in your bowel so it can be seen on the scan.

Sodium picosulphate

You should have been sent 1 sachet of sodium picosulphate. If you have not got the sachet, or have any questions about taking them, please contact the CT nurse coordinator.

Make sure that you are at home and have easy access to a toilet on the day that you take sodium picosulphate. It is not advised to take this at work.

Side effects of taking sodium picosulphate

Stay near a toilet once you have started taking the sodium picosulphate.

You will need the toilet often, and eventually have diarrhoea up to 3 hours after taking the first sachet.
You might have some bloating or stomach cramps.
You can use a barrier cream, such as zinc and castor oil on your bottom to stop it getting sore.

If the sodium picosulphate is taken as instructed, the diarrhoea should have stopped by the morning of the CT enema scan.

If it has not stopped and you are worried about needing the toilet on the journey to the hospital, make sure that you bring some extra toilet tissue with you. Plan your route carefully so you can get to a toilet if you need it.

Barium

Barium is a liquid dye that you drink. The liquid dye shows up on the CT scan of your bowel, helping the doctor to read the scan.

Most of the dye is not taken in by the body, and gets mixed with the poo in your large bowel. The dye will eventually be passed out of your body and might make your poo look white in colour.

You should have received 1 can (225ml) of barium. You can also collect this from the pharmacy yourself in some cases.

You need to take barium in 2 separate doses.

You can mix barium in water or juice as needed.

Making changes to your diet

You have also been asked to make some changes to your diet the day before your scan.

You should only have small meals made up of low residue foods before your scan.

This will help the sodium picosulphate and barium work properly.

Low residue foods

You can eat fats such as butter and margarine, only a small amount of these should be used
You can eat eggs, especially boiled and poached
You can eat cereals such as cornflakes and crisped rice cereal, but not bran
You can eat cream cheese, cottage cheese or cheese sauce
You can eat potatoes without the skin, boiled, creamed, mashed or baked, but not roasted or deep fried (chips)
You can eat plain white pasta, noodles or boiled rice
You can eat meat or fish
You can eat gravy made from stock cubes (white flour or corn flour can be used to thicken)
You can eat white bread or toast
You can eat sugar or sweetener
You can eat clear jelly

Food and drink to avoid

Do not eat vegetables
Do not eat fruit
Do not eat brown bread
Do not eat brown rice
Do not eat brown pasta
Do not eat jam
Do not eat nuts
Do not eat biscuits
Do not eat crisps
Do not drink alcohol

The day before your scan

Follow these instructions on how to prepare and when to take the sodium picosulphate and barium (E-Z-CAT). There are also examples of what you can eat and drink on the day before your scan.

Take the sodium picosulphate.

Step 1: mix the contents of the sachet in 150ml (about 1 cup) of cold tap water. Do this in a large glass or jug, as the mixture may fizz over.
Step 2: stir the solution for 2 to 3 minutes. If it becomes warm when you stir it, wait until it has cooled down before drinking the whole solution. Once the solution is ready, drink it immediately. The solution will appear cloudy.

You can have tea or coffee (with milk and sugar or sweetener, if needed).

You can also have other clear fluids, such as water, clear soups, herbal tea, black tea or coffee, or diluted cordials or fruit juice (smooth with no fruit bits).

Choose one of the following:

30g crisped rice cereal or cornflakes with 100ml of milk
2 slices of white bread or toast, with a small spread of butter or margarine and honey
1 boiled or poached egg, and 1 slice of white toast or bread with a thin spread of butter or margarine
50g of cottage cheese or cream cheese, and one slice of white toast or bread with a thin spread of butter or margarine

Drink half the can of barium.

You can have tea or coffee (with milk and sugar or sweetener, if needed)

Choose one of the following:

75g meat or fish with gravy
2 boiled or poached eggs
100g cream cheese or cottage cheese

Add one of the following:

2 slices of white bread or toast, with a small spread of butter or margarine
2 egg-sized potatoes without skins, with a small amount of butter or margarine
2 tablespoons of plain white pasta or rice

Drink plenty of clear fluids, preferably water.

Tea and coffee should now only be black (no milk).

Do not have any solid food, milk or other dairy products until after the scan.

Drink the remaining half of barium at 6pm.

Do not have any solid food.

You can have clear soup, a meat extract drink or clear jelly.

Do not eat any more food until after you have had the scan.

Throughout the day drink plenty of clear fluids so you do not get dehydrated. For example water, squash, fizzy drinks, clear strained soup, clear stock.

As a guide, try to drink about 1 glass every hour (during waking hours).

Signs that you are dehydrated include dizziness, headache and confusion.

People with diabetes or restricted diets for religious or ethical reasons should contact the CT nurse coordinator for dietary advice.

On the day of your CT scan

Read about what happens during and after having your CT scan.

Preparation with sodium picosulphate and barium (E-Z-CAT)