Posts tagged ‘swallowing’

August 4, 2014

We Love… Get Your Rear In Gear!

Katie Couric VF 2012 Shankbone 2 by via david_shankbone Flickr Copright Creative Commons Attribution 2.0 Generic (CC BY 2.0)To end this series on GI imaging, we thought we’d shine a light of hope and health by talking about an organization we love… Colon Cancer Coalition!

 

This is an amazing group of people dedicated to the knowledge that early detection of colon cancer saves lives! Their mission?

 

“Empower local communities to promote prevention and early detection of colon cancer and to provide support to those affected.”

 

Katie Couric, through her own personal loss and resilience, has helped make colorectal cancer a nationally known and talked about  issue (and for this we are grateful). The Colon Cancer Coalition reminds us to Get Your Rear In Gear! This program in cities across the US funnels money back into the participating cities, supporting local education and screening efforts. Check for events in your community here.

 

Early detection is the key to saving lives from colon cancer which is a largely preventable disease – in most cases, colon cancer starts from small growths called polyps. If these are found early, no colon cancer will develop! From a healthy diet and exercise to regular check-ups and knowing the signs of colon cancer, we can all make a difference. Regular screening with colonoscopy at age 50 for folks of average risk can and will make a difference.

 

Catch up with the Coalition on Twitter. (We follow them too.)

 

Time to celebrate life – and kick cancer’s butt!

 

 

(Image credit: Katie Couric VF 2012 Shankbone 2 by david_shankbone via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 18, 2014

Imaging of the Lower GI

Barium and Air lower GIYou would probably not consider a barium enema an exam to add to your bucket list, but this imaging study of the colon has the potential to save lives and diagnose many different conditions of the large intestine. While not the most pleasant test we perform, it does create beautiful (ok – we think they’re beautiful!) images of the colon, allowing us to find problems and prevent future ones.

 

So, why would you need an imaging study of the lower gastrointestinal (lower GI) tract?

 

A barium enema shows the anatomy of the large intestine or colon. Colonoscopy allows direct visualization of the mucosal lining and the inside of your colon through a long endoscope, and is often the first study performed for evaluation of the colon. Barium enema is an alternative means of imaging the colon that is less invasive, but not as sensitive at finding some things (especially smaller polyps). Your doctor may recommend lower GI imaging if you have the following symptoms:

 

  • blood in stools
  • change in bowel habits
  • constipation
  • excessive or chronic diarrhea
  • inexplicable weight loss
  • irritable bowel syndrome (IBS)
  • pain in the abdominal region
  • to screen for colon cancer – colonoscopy or CT colonography are often the studies of choice; if colonoscopy cannot reach all of the colon, barium enema may be used to screen the part of the colon not seen; screening for colon cancer is important as most colon cancers start as small growths called polyps – if such polyps are removed, no cancer will develop!

 

How do you prepare for lower GI imaging? What’s to expect?

 

Tests of the lower GI are performed… carefully. In order to find masses or abnormalities of the mucosal lining, the colon must be completely empty. A preliminary prep to accomplish this is necessary for most studies. It will require fasting for a time period, around 24 hours. The prep will include a combination of laxatives and enemas with the goal that all particulate matter is eliminated from your system by the morning of the test. Any medications necessary should be taken with a small amount of water.

 

We occasionally do the study on children. Special preparations may or may not be necessary depending on the age of the child and the conditions being evaluated.

 

The test involves radiation, so will not be used on pregnant women or those who might be pregnant. Let your radiologist know if you have an allergy to latex.

 

We will start the procedure with a preliminary x-ray or film of your abdomen. This allows the radiologist to make sure the prep has worked and the colon is empty. It also allows us to assess for signs the test should not be done, such as when there is a possible obstruction or bowel perforation. The exam involves placing a catheter into the rectum, where a small balloon is inflated. Barium is introduced through the catheter into the rectum by gravity. Room air is then introduced. We use fluoroscopy to get the right amount of barium and air into and coating the colon. This will involve changing your position on the table (lots of rolling!) and changing the table position. Once the colon mucosa is coated with barium and distended with air, a series of x-rays in dedicated positions will be taken so that all parts of your colon will be seen.

 

It will help you tolerate the study if you concentrate on breathing – this actually relaxes the muscles in the wall of the colon, lessening any cramping you may experience.

What do we look for when imaging the lower intestinal tract?

 

We can find a wealth of information from the health of the mucosal lining to blockages. We will assess for normal anatomy and look for signs that all of your colon, from the rectum to the cecum,  is seen. We can evaluate for:

 

  • tumors – both benign polyps and cancers
  • diverticular disease – diverticula are saccular outpouchings from the colon wall which can become inflamed
  • inflammation as can be seen in inflammatory bowel disease or colitis
  • strictures or narrowings
  • blockages in children, as from Hirschsprung’s disease or from intussusception, which can also be treated and reduced with a barium enema

 

What happens after a lower GI exam?

Your radiologist will review all of the films. Once all areas of the colon have been well-seen, the catheter will be removed and you will be allowed to the restroom. Images after using the restroom may or may not be needed.

 

Your radiologist will evaluate all of your images and the final report will be sent to your referring physician.

 

Be sure to drink plenty of water following the procedure. This is needed to flush the remaining contrast agents from you system. You can resume your normal diet immediately.

 

The well-being of your gastrointestinal system is important, and the barium enema is an imaging tool which can provide valuable information, keeping you on the road to your best possible health.

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

July 16, 2014

Upper GI Pain and Imaging

UGI imagingEver wondered what happens when you swallow or what your stomach looks like? Upper GI (gastrointestinal) and esophagrams are tests used to assess  the first part of the gastrointestinal system and can be used to answer these questions and much more.

 

Why would you need one of these tests?

These exams may be used for a variety of symptoms including but not limited to:

  • Abdominal pain
  • Epigastric pain
  • Heartburn or other symptoms of reflux disease including chest pain or discomfort, a burning sensation, or excessive burping; more unusual symptoms of reflux can include sinusitis, anosmia (loss of smell), aspiration, and chronic cough.
  • Trouble swallowing
  • Choking
  • Vomiting
  • Blood in stools
  • Ulcers

 

Prior to the study:

It is very important that a patient coming in for an upper GI imaging procedure not eat or drink anything after midnight the day before the exam. In order to look at the structures and anatomy, the stomach and esophagus must be empty. Even a small amount of water can keep the contrast material from coating and sticking to the lining of the structures which would limit what the radiologist can see. Due to radiation exposure UGI imaging is not used in women who are or may be pregnant.

 

It is okay to eat and drink before an esophagram.

 

You will change into a gown, removing all clothing that has metal. We don’t want metal buttons, zippers or underwires hiding any of your lovely GI structures!

How are the tests done?

For an UGI we start with a preliminary x-ray or image of the abdomen- this makes sure there is no blockage before we begin the test. In order to optimally see your GI tract on x-ray using fluoroscopy, we have to give you a contrast material by mouth. General GI imaging can be done with contrast material such as barium and crystals of gas – the barium lines the esophagus (the connection from the mouth to the stomach) and the stomach; the crystals create gas which expands the organs, allowing radiologists to beautifully see the mucosal lining.

 

The contrast travels thru the pharynx, esophagus, stomach and duodenum; observing real-time with fluoroscopy allows us to see function as well as anatomy.

 

Images are obtained of all parts of the upper GI tract, usually starting with you positioned upright and then horizontal. fluoroscopy allows a real time look at what is happening.  X-ray images are also recorded for better detail.

 

For an esophagram, we focus on the pharynx and esophagus only, using oral contrast agents, gas and sometimes foods like crackers coated with barium paste.

 

What can be found using these tests?

  • masses- anywhere along the upper GI tract; these can be benign like polyps or cancerous;
  • ulcers (gastric or duodenal);
  • hiatal hernia (a condition where the stomach is positioned above the diaphragm predisposing to reflux disease and it’s complications like Barrett’s esophagus which is a pre-cancerous condition; this is one of the reasons to not ignore your reflux symptoms!);
  • reflux -we can see the barium going from the stomach back up into the esophagus- we will try different positions and maneuvers to try to elicit reflux;
  • esophagitis or gastritis-conditions of inflammation from many different causes;
  • congenital abnormalities-sometimes the upper GI tract is not connected normally or there may be congenital cysts or masses along the upper GI tract;
  • motility disorders- most often of the esophagus; imaging real-time allows us to see how your upper GI tract is functioning
  • swallowing disorders

What happens after the test?

The radiologist may be able to discuss some of your results at the end of the test. A final report will be made by your radiologist after reviewing all of the images, with the official report going to your doctor.

 

We will ask that you drink lots of fluids to help flush the barium out of the system! (Besides, drinking water is good for you no matter what!). You can resume your normal diet immediately.

 

Upper GI exams can result in amazing images and can be a key to diagnosis of a wide variety of conditions. Seeing your body in action helps us keep you on the road to your best possible health!

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!