colonography

Virtual Colonoscopy (VC)

What is Virtual Colonoscopy?

Virtual Colonoscopy (VC), also referred to as CT colonography or CTC, is a safe exam used for
colon polyp screening. The entire inner surface of the colon can be seen with VC. A computed
tomography (CT) or “CAT” scan creates images of the inside of your colon. VC allows the
doctor to see your colon and to take a limited look outside the colon for problems in the abdomen
and pelvis. The main purpose of this exam is to screen for growths (polyps) in the lining of the
large intestine (colon and rectum). Adults ages 50 years and over should have screening for
colon polyps.
If a large polyp or growth is found in your colon, a standard colonoscopy may be needed to
remove the polyp. “Large” polyps are those that are 1 cm (about ⅜ inch) or greater and should
be removed because they have a higher chance of turning into cancer. A growth of this size is
present in about 5% of adults. A nurse will arrange for the standard colonoscopy, if needed. If
this occurs, you will need to have someone drive you home. If it can be scheduled on the same
day or next day, a second bowel prep will not be needed.
Doctors at can now watch a small colon polyp over
time. Smaller polyps, 6 - 9 mm (about ⅓-¼ inch),
If you have diabetes, please call your
can be safely watched by having a follow up VC doctor to discuss how your diabetes
exam in 1-3 years. Small polyps can also be medicine (oral diabetes pills and/or
removed by standard colonoscopy, the same day or insulin) doses should change before the
VC. Test your blood sugar more often
the day before this test. Also check your Getting Ready for your VC Exam
blood sugar the morning of your test. If your blood sugar level is low (less than To prepare for this exam, you must clean your colon. Follow the guidelines in your bowel prep some glucose tablets or drink 4 ounces of kit that includes laxatives and the special clear liquid diet. If you feel you cannot complete the Always recheck your blood sugar level to bowel prep, tell the VC nurse before your exam.
still be able to do the VC unless you need If you get diverticulitis within 4-6 weeks before to eat solid food to keep your blood sugar your VC exam, the VC office will reschedule your at a normal level. If the blood sugar ever exam for at least six weeks after your treatment is gets too high or too low and you can’t complete to allow time for your colon to heal. bring it back to normal, call your primary If you are taking Coumadin (warfarin), Plavix
(clopidogrel) or other prescription blood thinners,
do not stop taking them unless your doctor tells you to stop them. If a polyp is found that
should be removed, you will need to consult with your doctor and set up the standard
colonoscopy at a later date.
If you are not taking Coumadin (warfarin), Plavix (clopidogrel) or other prescription blood
thinners and you would like to have the option of a same-day standard colonoscopy if a polyp is
found, you must stop the medications listed below 5 days prior to your exam. These
medications include:
y aspirin y anti-inflammatory drugs (ibuprofen, Advil®, Motrin®, naproxen, Aleve®) y anti-arthritic medicines y iron, or multivitamins with iron
You may take Tylenol® (acetaminophen) for pain if needed.
Taking these medicines does not affect your VC exam, so if you would not be able to have a
standard colonoscopy the same day because you would not have a driver, or you have other
plans, you may continue taking them. If you are taking Coumadin® (warfarin), Plavix®
(clopidogrel), or other prescription blood thinners, you may also keep taking the medications
listed above because if a polyp is found, the standard colonoscopy would be arranged for a later
date. If you have any questions or concerns about stopping a medicine please contact your
doctor.
Take all other prescribed medicines with sips of water before your VC (if you have diabetes, see
the box on page 1). Do not eat or drink after midnight on the night before the exam.
When to arrive for your VC Exam

We will contact you by phone to remind you of the date for your VC exam. You do not need to
have a family member or friend drive you to the VC exam, as you will not be given any medicine
that will make you sleepy. If you need a standard colonoscopy the same day, then you will need
to arrange for someone to drive you home. There is about a 90% you will not need colonoscopy.

During the VC Exam

The VC exam usually takes 15 minutes or less to complete. You will not need pain or sedation
medicine or an IV for this exam. You will be asked to change into a hospital gown for the exam.
You will be taken to a CT exam room where you will lie on the CT exam table. A small, flexible
tube (smaller than a pinky finger) will be gently placed a very short distance into your rectum
(the feeling is like having a digital rectal exam). Carbon dioxide will be placed slowly into your
colon. The exam should not be painful, though you may have some abdominal fullness,
discomfort, or cramping during the exam. You may feel the urge to have a bowel movement.
These feelings should go away as soon as the exam is over. CT images are taken of your
abdomen and pelvis while you are lying on your back and then on your stomach. Each time you
move, you will be asked to hold your breath for about 10 seconds while the CT scanner takes
pictures.
After the VC Exam

A VC team member will call you with the results in about two hours. Most patients return to
work or other activities after the exam is over and remain available by phone.
• If you wish to have the polyp removed on the same day as your VC, please do not eat or drink until you hear from us. If you need to have a standard colonoscopy, the VC team can arrange this second exam for the same day or a future date. If taking Coumadin (warfarin), Plavix (clopidogrel), or other prescription blood thinners, you may resume your normal diet after the exam. If a polyp is found that should be removed, your standard colonoscopy will be set up at a later date.
Contacts

VC Nurse Coordinator: XXX
If you need to reschedule, call XXX. If you need to change your visit please provide a notice
of five business days.
If you have an urgent concern after normal business hours, please contact your primary care
doctor’s on-call service.
If you are in need of immediate medical help, call 911 or go to the nearest Emergency Room.

Source: http://www.virtuoctc.com/pdfs/VC%20general%20instructions%20for%20pts.pdf