Radiocontrast Agents

I’ve finally managed to track down the name of the odd-tasting radiocontrast agent they gave me orally when the dumb doc thought I had appendicitis.  The trade name is Gastrografin and it’s a water-based iodinated radiocontrast agent.

I’ve also had barium sulfate for an esophogram.  So I’ve decided to list the pros/cons of each:

Gastrografin:

PROS:

  • Not usually used with thickening agent so it’s quicker to swallow.

CONS:

  • Tastes like stale, dusty apple pie.  (Actually unflavored Gastrografin is almost undrinkable because of the horrible taste – it’s always mixed with a flavor if given orally.)
  • Gives terrible diarrhea.
  • You end up having to drink a lot more of it than you would of barium sulfate because it doesn’t coat the GI tract like barium does.
  • Contains iodine so you have to drink lots of water for a few days to keep your kidneys from suffering.

Barium sulfate:

PROS:

  • Can be flavored and doesn’t taste as bad as Gastrografin.
  • Coats the GI tract so you don’t need to drink as much.
  • Tastes and feels exactly the same going down as coming up.
  • No need to drink an assload of water.
  • Doesn’t give you diarrhea.

CONS:

  • Unflavored, it tastes like Pepto Bismol but thicker.
  • Makes you crap white for a few days.
  • Can make some people nauseous (but doesn’t seem to bother me – I only know that it tastes the same coming up because an esophogram requires you to drink it while almost upside-down so gravity tends to reverse the normal course of things – boy was that a mess, heh).
  • Affects your sense of taste for a while after drinking.

Overall, I prefer barium sulfate.  But I understand why they used Gastrografin for the abdominal/pelvic CT for appendicitis:  In the event that I had a ruptured appendix, barium leaking into my abdominal cavity would’ve been very bad.  Gastrografin doesn’t pose that risk.

IV iodinated CT contrast, BTW, is interesting.  First, the machine that pumps it in makes your arm feel funny.  Second, it causes a flushing sensation all along the major blood vessels in your body and makes your eyelids, breath, and crotch feel hot.  It makes you feel like you peed your pants.  But it only lasts a few seconds.  And it’s NOTHING like getting slammed full of Narcan – that feels like being immersed into boiling water.  (Idiots thought I had OD’d on cocaine when I’d had a terrible panic attack.)

Both CT scans and esophograms are kind of neat, when you get into the biophysics of them.  And it’s really neat to watch the fluoroscope while you’re swallowing the barium.  According to the dosimeter during the esophogram, I absorbed 0.017 Gy of hard photon radiation in the X-ray spectrum, which is pretty minor (0.002 Gy/frame, 19.2 Gy*cm2 dose-area product).  During the abdominal / pelvic CTs, I had a total of four scans and absorbed 0.0053 Gy per scan for a total effective dose of 0.0212 Gy.  During the head CTs I had, I had two scans and absorbed 0.0015 Gy per scan, for a total effective dose of 0.003 Gy.  For reference, background radiation in the UK is about 0.001 Gy/year and standing 1 mile away from the Little Boy or Fat Man bombs would give you about 1Gy of acute whole-body exposure. (Liquidators at Chernobyl ended up with around 0.3 Gy/hour of whole-body exposure.) Around 4.5Gy of whole-body exposure is fatal in half the population.

BTW, the tags for this article were generated through the new e-mail keyword service.  I won’t post the address since it’s a big DoS-hole.

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  1. #1 by Chadwick on January 18, 2011 - 10:17 PM

    If I wasn’t editing the theme right now and checking out the new footer, I’d never have seen this post. I can’t say I’ve ever had Gastrografin, and it sounds like I’d rather I never did. I’ve always rather liked (well, maybe liked is too strong a word…strongly tolerated?) barium sulfate when I’ve needed to get scanned. I mean, it’s not an entirely pleasant thing, especially since they just force you to chug like a gallon of the stuff, but it’s pretty much entirely inoffensive, and certainly goes down smooth and cool.

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