Patient Forms & Information

Fluoroscopy
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Arthrogram

Do NOT have anything to eat or drink 3 hours before you examination.

Barium Enema (BE) / Barium Enema with Air

Pick up the following non-prescription medications from your local pharmacy:

  1. Magnesium Citrate – One (1) 10 oz bottle
  2. Dulcolax (Bisacodyl) – Four (4) tablets  (5 mgs. each)
  3. Dulcolax (Bisacodyl) – One (1) suppository

On the day before your Barium Enema test:

  • 8 AM   Have a clear liquid breakfast without milk products.  This meal may include: clear broth or bullion, clear or strained fruit juices such as grape or apple juice, clear jello or gelatin, black coffee or tea with sugar but without milk or milk products, non-carbonated beverages, orange, raspberry or lemon ice (no sherbet).  No milk products, fruits or vegetables.
  • 12 Noon   Have a clear liquid lunch without milk products, using the same guidelines as breakfast
  • 1 PM Drink a full 8 oz glass of water.  Repeat this every hour until bed time.
  • 4 PM Drink the bottle of Magnesium Citrate- this can be chilled to make it easier to drink.  Also drink one 8 ounce glass of water.
  • 6 PM Have a clear liquid supper, using the same guidelines as breakfast and lunch.
  • 8 PM Take the 4 Ducolax tablets with 8 ounces of water.  Do not chew the tablets. These tablets usually produce a bowel movement in 6-12 hours.

On the day of your Barium Enema examination:

After removing the foil, the Ducolax (Bisacodyl) suppository should be inserted rectally 2 hours prior to arriving at the Radiology Department.  While lying on your side with thigh elevated, insert the suppository into the rectum and gently push in as far as possible.  Try to keep the suppository in for 20 minutes even if the urge for evacuation is strong.  Bowel evacuation usually occurs within 15 to 60 minutes. You may take your normal medications with a small amount of water. Nothing else should be taken by mouth.

Esophogus / Swallowing Function (Barium Swallow)

Nothing to eat or drink for 1 hour until your exam. (For Infants – Bring empty bottle or sippy cup to the appointment.)

Fistulogram

No Prep

Loopogram (AM Appointment)

Do NOT have anything to eat or drink after midnight the evening before you examination. If you need to take medication which cannot wait until after the examination is over (usually about mid-morning), take it with a tiny sip of water. If you are a diabetic and cannot fast, please let us know in advance of your examination.

Loopogram (PM Appointment)

You may have a light breakfast (no milk products) at 9am the morning of your procedure

Portacath Check (Venogram Interior Vena Cava)

If you are taking Blood Thinners; contact your doctor prior to the scheduling the exam to discuss any possible reactions.  Do NOT have anything to eat or drink 3 hours before you examination.

Small Bowel

Do NOT have anything to eat or drink after midnight the evening before you examination. If you need to take medication which cannot wait until after the examination is over (usually about mid-morning), take it with a tiny sip of water. If you are a diabetic and cannot fast, please let us know in advance of your examination.  This study may take several hours.

Upper GI Series

Do NOT have anything to eat or drink after midnight the evening before you examination. If you need to take medication which cannot wait until after the examination is over (usually about mid-morning), take it with a tiny sip of water. If you are a diabetic and cannot fast, please let us know in advance of your examination.  (For Infants – withhold the last feeding. This usually means no feeding 3 – 4 hours prior to the test. Bring empty bottle or sippy cup to the appointment.)

Upper GI Series with Small Bowel

Do NOT have anything to eat or drink after midnight the evening before you examination. If you need to take medication which cannot wait until after the examination is over (usually about mid-morning), take it with a tiny sip of water. If you are a diabetic and cannot fast, please let us know in advance of your examination.  This study may take several hours.


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