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Fluoroscopy

​​Fluoroscopy is ​​​​​an imaging test that helps the radiologist see the surface of the gastrointestinal tract and check for any abnormalities.

Fluoroscopy
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Fluoroscopy is the medical imaging that shows a real-time X-ray images on a monitor. It can be used to assess or diagnose various diseases. Often, a radiological contrast may be used in an imaging scan. Barium sulfate and Omnipaque are commonly used in fluoroscopy studies to highlight certain areas better in the X-ray images that are obtained during the procedure.

The most common studies are gastrointestinal studies, arthrogram of the joints, urology studies, lumbar punctures and insertion of naso-gastric tube. Other examples of procedures which use fluoroscopy imaging are defecating proctogram, sniff test, etc.
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​Barium fluoroscopy study is one type of gastrointestinal study that is able to identify gross abnormalities like growths of tumours, ulcers and other inflammatory conditions, such as strictures, hernias and polyps. A barium mixture drink will be given during the procedure. Gas granules will also need to be swallowed.

​During the examinations, patient is required to turn to certain position, stand straight or lying down to acquire diagnostically valuable images. Occasionally, there may be a combination of standing and lying down in one procedure. Radiologist will guide you along the procedure.

Water soluble contrast study is the other type of gastrointestinal study that use omnipaque to highlight the gastrointestinal organs, which may include the oesophagus, stomach, small and large intestines to assess possible perforation, leakage after surgery, or intestine obstruction.

Arthrogram is commonly to assess la​bral tear or TFCC tear. For better assessment in the subsequent MRI examination, patient comes for fluoroscopy to inject the MRI contrast which will be highlighted in MRI images.


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​As with most radiological procedures, there may be preparations that will be required to be done by you. Below are some preparations needed to ensure a successful and smooth fluoroscopy appoinment.

Fasting
For patient coming for gastrointestinal (GI) studies, no solid food and smoking are allowed 6 hours prior to the scan.

For dia​betes patients, please inform the radiologist prior to the procedures due to potential hypoglycemia.​

Contrast Media Allergies
Inform the requesting doctor if you have had radiological dye allegies from previous scans before. An alternative dye may need to be prepared.

Drug Allergies
Inform the requesting doctor if you have any prior known drug allergies and if you are on any medication.

Pregnancy
Please consult with your doctor if you are uncertain about pregnancy as the procedures will involve radiation.

If you are coming for a Barium Enema, please do the following:

3 days before the examination:
  • ​​To start on a low residue diet until the day of examination. Meat, fruits, and leafy vegetables should be avoided. 
  • To drink plenty of plain water.

2 days before the examination:
  • ​To drink a mixture of 40ml of lemon sweet purgative dissolved in a glass of plain water at 8.00pm.
  • To take 2 tablets of Bisacodyl with plain water at 10.00pm. 

Morning of examination:
  • ​To insert the Bisacodyl suppository into the rectum at 6am. Let it stay in the rectum between 30 minutes to 1 hour before emptying the bowel. 
  • To drink only small quantities of water with any required medication before coming for the scan. 

Outfit
You will be required to change into a hospital gown, which will be given before the procedure. Ensure that all metallic objects/ radiopaque items are removed from the neck, chest, and abdomen area before the start of the scan.

Procedure
Depending on the procedure that you are coming for, the entire duration is about 30 min to an hour. As fluoroscopy studies are largely dependent on many factors, the procedure duration varies from patient to patient.

For patients coming for Barium GI study:
Contrast media in the form of a barium drink prepared by our staff, will be given to you to ingest at different points of the procedure, as directed by our radiologist. As this is used to highlight the various parts of the gastro-intestinal tract, you may be required to change positions frequently to obtain the best x-ray images that will assist our radiologist in their reporting. Some patients coming for barium studies may also be required to swallow some effervescent powder to help better outline the stomach. ​

If you are coming for an enema study: 
​You will not be drinking the barium drink. Instead, a rectal tube will be inserted and the contrast will pass through it.

For patients coming for arthrogram: 
N​o special prepared is required prior to the examination. The procedure will be maintained as sterile condition and the radiologist will inject MRI contrast under fluoroscopy guidance. Your joint will feel the tightness and fullness during the procedure and it should relieve within 2-3 days.

For patients coming for urology studies:
​The omnipaque will be given via the urine catheter. The radiologist will guide you to turn certain position for better visualization of the area of interest.

Our fluoroscopy-trained nurse, radiographer and radiologist will be with you inside the procedure room throughout. Should you need any help, please do not hesitate to approach them. Upon the completion of the study, you will be allowed to change into your clothes.

Our radiologists will review and report your scan images. A small number of patients may be recalled back by the Radiologists after the scan for additional imaging to ensure accuracy of the CT report. The scan results will be sent electronically to your referring clinician who will discuss it with you on your next appointment.

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For Barium GI studies

Do drink plenty of water and eat more fruits and vegetable to minimize constipation and encourage passing out of remaining barium in the gastrointestinal tract.

It is also common for stools to be stained white from the barium contrast after procedure. This is normal, and should stop after a few days.​

For arthrogram

Please avoid strenuous activity for the coming days. The tightness of the joint is normal and it will release. Do monitor the signs of infection and if the discomfort continues, please go GP for follow up assessment.

For lumbar puncture

Patient is required to rest in bed for the next 4 hours and nurses will do the necessary monitoring.

For NGT insertion​

While using the naso-gastric tube, prevent it from dislodging and take note for the date due for change if it’s used for long-term.


If you have any other enquiry, please feel free to ask our radiologist and radiographer before you leave the hospital.

​   Contributed by Department of Radiology