General Question

flo's avatar

Does Contrast come in either IV or drink form or are there other options?

Asked by flo (12974points) January 13th, 2015

Are there other options, as in swallowing something like a tablet etc. and washing it down with the required litre of water just for those people who can’t take the taste, (no explaining taste some people don’t like honey) esp. a whole litre if not more?
Here
is what I’m referring to. It is for a child.

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9 Answers

Seaofclouds's avatar

There is IV contrast and liquid contrast that patients drink. Which one is used depends on what they are doing the scan for. The contrast is used to help show different things during the scan. The two types are not interchangeable because they would not show up in the same places during the scan. As far as I know, there is no pill form for contrast.

FireMadeFlesh's avatar

There are several types. However, you may need more than one type – for a CT scan, it is common to require IV and oral contrast. IV contrast is used to enhance the vascular system and the organs that have a good blood supply. The contrast you drink is for the bowel, which doesn’t enhance with IV contrast. Contrast can also be injected directly into the spinal canal or brain ventricles for certain procedures.

I work in a radiology in a paediatric hospital, and deal with this issue every day. There are a few options, in order of priority:

1. Gently try to convince the child, depending on his/her age, of the importance of drinking it.
2. Dilute the contrast with juice, lemonade, or another soft drink (NOT milk) rather than water. The sugar can mask the taste of the contrast.
3. Oral contrast is usually either Barium or Iodine based. If one isn’t working, try the other. Neither taste good though.
4. If the scan absolutely requires contrast, and point 2 doesn’t work, a nasogastric (NG) tube can be inserted, and the contrast injected directly into the stomach. If the child has reflux, a transpyloric tube (TPT) may be preferable, but these can be difficult to insert.

flo's avatar

Thank you both.

@FireMadeFlesh The poblem is step number one, too young to reason with/convince. .As well, too fussy re. the taste of things, esp. that much, a litre or so. No way possible.
I hope they will come up with something that can be swallowed or something, and then chased down with water. Over and done Wouldn’t that be great?

FireMadeFlesh's avatar

@flo A litre is overdoing it for a child. We give 400mL from about 4–10 years, and 600mL from 10 years to mid-teens. Only from mid-teens onwards should a litre be used. Try point two though – it makes absolutely no difference if the contrast is diluted with juice or soft drink.

It would be great if it could be in tablet form, but unfortunately that isn’t possible. Whatever new techniques are devised, it will always involve a lot of volume, because that’s what it takes to fill the bowel. It’d just be nice if they could improve the taste.

flo's avatar

@FireMadeFlesh I’m not a health care worker by the way, re. number 2. “the contrast with juice, lemonade, or another soft drink…”
I don’t think they ask the child’s favorite taste, they just bring the solution, if I heard right. Even if they improve the taste that is subjective matter. If a person hates the taste of x or y or z, sugar or lemon, there is no improving on it. In this case health care is limited for people who like sugary things. Aspirin etc. come in tablet form or capsule form why not contrast? In this case health care is only for people who like sugary things.

Seaofclouds's avatar

@flo Contrast does not come in pill form because you need the volume of the fluid to enhance the image on the GI tract on the CT scan. It is not likely that a pill would be able to break down to the volume needed to show the whole GI tract on the scan. I had to drink contrast once and it was not sugary at all. It was a thick, chalky substance. It had no particular flavor to it. That was a long time ago though. They have made a lot of progress in the taste of the contrast since back then.

flo's avatar

It is unlikely that man can go to the moon.

FireMadeFlesh's avatar

@flo Please see the final paragraph of my previous post. It is all about the volume. For contrast to come in tablet form, it would need to rapidly expand in size within the bowel. This is highly dangerous, as an increase in volume would increase pressure, and potentially rupture the bowel. Even if it were possible to expand within the bowel safely, the appearance this would give on a CT scan would be a false positive, as an over-full bowel can be a sign of something being wrong.

Unfortunately we cannot ask the child’s favourite taste either. We can present them with options, but if their favourite taste was chocolate they would be sorely disappointed, because the contrast cannot be given with anything involving dairy or fats. There will always be limitations in healthcare, and we can only present the options available.

flo's avatar

@FireMadeFlesh can’t debate the the technicalities, at all, since I’m not in the area.
“It would be great if it could be in tablet form, but unfortunately that isn’t possible.” Now maybe, but in the future? Experts in different areas have always debate things, amongst each other, and one day, bingo someone comes up with a way to solve the problem. There are innovations….how often would you say?

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