Scheduling An Appointment Virtual Colonoscopy Exam Preparation Stanford Radiology Scheduling Center For 7days before the test: Phone: 650-723-6855 DO NOT take iron pills (Ferrous Sulfate). DO NOT EAT foods with seeds such as poppy, tomatoes, watermelon, or cucumbers. Avoid celery, grapes, Fax: 650-723-6036 green peas, beans, seaweed, popcorn and nuts. For maps and directions, go to: Day before the test: www.imaging.stanfordhospital.com Starting at midnight, drink clear liquids only: Clear liquids includes water, tea with no milk, black coffee, Virtual 7-UP, ginger ale, apple juice, white grape juice, white cranberry juice (no juice that is red or purple), clear soup broth, gelatin (no red, blue, green or purple), popsicles (no red or purple). Redwood City Colonoscopy Stanford Medicine Outpatient Center You may wish to place the kit in the refrigerator to make the contents more pleasant to drink. Or, you may 450 Broadway Pavilion B, drink them at room temperature. Redwood City, CA 94063 Do not eat any solid food while on this diet. Do not drink alcohol. No dairy products. Stanford Medicine Imaging

Step One - 11:00 am Take two Bisacodyl® (Dulcolax) tablets (5 mg each) with 1 glass of clear liquids. Hours: Monday-Friday, 7:00AM to 5:00 PM Services: MRI, CT, Diagnostic X-Ray, US, Bone Step Two - 2:00 pm Drink one bottle (296 mL) of magnesium citrate. Follow this with 6 cups of clear liquids over Density the next 90 minutes. Step Three - 5:00 pm Directions: From South (San Jose)-Take US-101 Mix package of barium sulfate (EZ CAT) with 450 mL of water. Drink. North toward San Francisco. Exit CA-84/Woodside Step Four - 5:30 pm Drink the second bottle (296 mL) of magnesium citrate. Follow this with 6 cups of clear Road West (18 miles). Take Woodside Road to liquids over the next 90 minutes. Broadway Street (.7 mile). Turn left on Broadway Step Five - 8:00 pm Mix 2 bottles (60 mL total) of diatrizoate (Gastrografin) in 1 glass of clear juice, soda, or Street. Stanford Medicine Outpatient Center will be water. Drink. on the left (.6 mile). 12:00 MIDNIGHT No Food or Liquids From North (San Francisco)- Take US-101 South toward San Jose. Exit CA-84/Woodside Road West The day of the test be sure to take your blood pressure and heart medicines with a sip of water. (25 miles). Take Do not eat or drink anything else. Woodside Road to Broadway Street (.3 Special Precautions mile). Turn left on Broadway Street. In general, you can (and should) continue to take any routine prescribed medications during the preparation. Stanford Medicine However, take them 1 hour before or at least one hour after taking the laxative (magnesium citrate). Outpatient Center In the event that polyps are found on the virtual colonoscopy, certain eligible patients may choose to will be on the left (.6 undergo same day traditional colonoscopy, and removal of polyps (polypectomy) may be performed. mile). For this reason, patient taking anticoagulants, aspirin, NSAIDS (e.g., Advil, Aleve, Motrin), plavix, supplements and/or vitamins should consult with their physician before scheduling a virtual colonoscopy. Your appointment is scheduled for: If you take blood pressure or heart medications, or prednisone or other steroids, take them before 7 am Date: with a sip of water on the day of the test. Information for Patients Sun Mon Tue Wed Thur Fri Sat If you are taking INSULIN the dosage may need to be adjusted the day prior and the morning of the test. Time: Contact your physician for instructions regarding dosage. and Families What is Virtual Colonoscopy? die of the disease every year - this is the 3rd What happens during the test? most common cancer diagnosed and the 2nd Virtual Colonoscopy is a medical imaging leading cause of death from cancer in the United After changing into a gown you will lie on the procedure which uses computed tomography States. In 2008 the American Cancer Society CT scanner table. The technologist will need to (CT), sometimes called a CAT scan, and approved virtual colonoscopy as an alternative to distend your colon by placing a small soft tube advanced computer software to produce two- traditional colonoscopy. into the rectum and administer CO2 gas. As and three-dimensional images of the colon that the gas is administered you may experience a can be viewed on a video screen. ACS guidelines for colorectal screening: bloated feeling and mild discomfort. You will • 50 years of age or older be scanned initially lying on your back and The major reason for performing virtual • A personal history of colorectal cancer or then turned onto your stomach and scanned a colonoscopy is to screen for polyps or cancers adenomatous polyps second time. Then you are done! in the large intestine. Polyps are growths that • A personal history of chronic inflammatory arise from the inner lining of the intestine. bowel disease (Crohns disease or ulcerative Some polyps may grow and turn into cancers. colitis) Virtual Colonoscopy Exam The goal of screening with colonoscopy is to • A strong family history of colorectal cancer or Preparation Kit find these growths in their early stages, so that polyps (cancer or polyps in a first-degree relative they can be removed before cancer has had a [parent, sibling, or child] younger than 60 or in 2 chance to develop. or more first-degree relatives of any age) • A known family history of hereditary Radiologist, Peter Poullos M.D. colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary What are the benefits of Virtual non-polyposis colon cancer (HNPCC) WALGREENS Colonoscopy? 875 Blake Wilbur Drive, Suite CC1101 The Stanford Diagnostic Imaging • Less invasive than traditional colonoscopy Palo Alto, CA 94305 Advantage • Procedure takes less time (30 minutes) than a (inside the Stanford Advanced Medicine Cancer Center) traditional colonoscopy • State-of-the-Art Technology: The latest • Sedation and pain-relievers are not needed, so PHONE: 650-838-0429 generation 64- and 128-Row CT scanners there is no recovery period FAX: 650-838-0447 • Abdominal radiology subspecialist • Patients can return to normal activities Mon-Fri 8am-7pm interpretations immediately after the procedure Sat 9am-3pm • Extensive experience in 3D Imaging • Lower risk of complications than colonoscopy • If polyps are found, Stanford Diagnostic • Ideal for patients with an increased risk of Pictured above is an example of how polyps may Imaging can coordinate eligible patients a CTVC-KIT (Bisacodyl (Dulcolax), EZ complications or elderly patients who cannot appear to a Radiologist when viewing a Virtual same day traditional colonoscopy with the CAT, Gastrografin) ® Colonoscopy tolerate a traditional colonoscopy Stanford Gastroentrology Clinic CTVC-KIT is available at this location • Stanford Diagnostic Imaging utilizes CO2 gas • Helpful when colonoscopy cannot be only. Pick-Up or Mail Delivery available American Cancer Society instead of air to inflate the colon. The gas is completed when the bowel is too narrow, obstructed, or elongated absorbed by the body and causes less cramping Magnesium Citrate – Over the counter The American Cancer Society estimates that and bloating than air thus ensuring that • Visualizes the entire bowel & available at any local pharmacy. Mail nearly 150,000 men and woman are diagnosed patients have a better experience. • Proven effective in large clinical trials delivery not available. with colorectal cancer and almost 50,000 will • Patient-Centric Environment • Patients tend to prefer virtual colonoscopy