Faecal Tagging with Barium

Faecal tagging is performed with a 40% weight/ volume barium suspension (Tagitol V®, E-Z-EM). The patients only have to drink a total of 60 ml: 20 ml at breakfast, lunch and dinner respectively. The patients are instructed to drink the barium at once after the meal.

We use barium as sole tagging agent. Several authors advocate the use of iodine or a combination of barium and iodine to achieve fluid tagging (Zalis and Hahn 2001; Zalis et al. 2003; Pickhardt 2003; Iannaccone et al. 2004). Although its efficacy in fluid tagging is well established, we are not in favour of using iodine. Why not ? In our experience of performing dietary faecal tagging with barium as sole tagging agent, only a few segments presented with a considerable amount of non-tagged fluid. The taste of the barium suspension is improved by adding a flavour (for instance apple flavour) whereas iodine has a bad taste. Furthermore, using iodine, adverse effects such as nausea, vomiting and diarrhoea quite

Fig. 4.2. The diet is presented in a box and provides meals and beverages on the day preceding CT colonography

frequently occur. In a recent study Iannaccone et al. (2004) described side effects in 10% of patients using 200 ml of iodine over two days.

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