If you’ve never had an MRI before and you’ve been referred for one all of a sudden, it can seem like a daunting prospect. However, an MRI provides incredibly useful imagery for your doctors about the extent and location of your disease as well as highlighting other issues such as strictures or abscesses. It is also probably the least invasive procedure for investigating Crohn’s and Colitis- other than stool samples of course! Once you’ve had one, any worries you had will hopefully be laid to rest but, as a helping hand, here is my guide to preparing for and undergoing an MRI of your abdomen.
Preparation
Some kinds of MRI such as scans of the pelvis require very little preparation. Having an abdominal scan however is a little more complex. In the context of IBD, abdominal scans primarily investigate the small/ large bowel. It is therefore necessary to fast (no food OR fluids) for usually around 6 hours before the scan so that a clear image can be taken. This means that you should aim to take your normal medication before this deadline.
When you arrive at the hospital you will be asked to fill out a consent form (if you haven’t already been given one or received one by post). This is a fairly short and simple document which will ask you a series of yes/no questions about your health such as if you’ve had recent surgery, if you have any metal implants or if you could be pregnant. These are just routine questions to ensure that it is safe for you have to have the scan. The form will likely also ask if you consent to being given a dye injection, usually given in the last 10-15 minutes of the scan. This dye is harmless and simply ensure that the clearest image possible is taken.
Once you have signed the consent form, you will be taken to the patient waiting room. Here you will be given some lactulose to drink along with between 0.5- 1 litre of water. So, as this is an honest guide, I have to declare that the lactulose is absolutely vile. I would definitely recommend the hold-the-nose trick to get that down. Luckily there is only one small plastic cup of the stuff- but whatever you do, do NOT try and down it in one! It will probably come back up and then you’ll have to start over, and nobody wants that. I usually get it down in around three- four large gulps.
One thing I cannot stress enough for people with confirmed or suspected IBD is that the lactulose is mixed with lemon juice when they give it to you (at least at my hospital it is). For me, lemon is an absolute no-go as it royally messes up my system. The doctors always warn you that the lactulose will give you the runs- that’s kind of the idea; to empty your bowels. But what I found out a couple of years ago is that it was actually largely the lemon having that effect! The first time I had the scan and asked for the lactulose without the lemon mixed in, I barely went to the loo at all afterwards! I was shocked! So, if you always get awful diarrhoea after an abdominal MRI or you know you are sensitive to lemon, it is absolutely worth asking your hospital if they use it and if they do, you can easily request it without.
Anyway, so after polishing off the lactulose, you will then have to drink a whole bunch of water to inflate your stomach for the scan. I would recommend brining some lightly coloured squash with you to mix with the water- I’ve never had any issues doing this and it gets rid of the taste of the disgusting lactulose at least! Once you’ve finished drinking (you’ll have around 40 minutes to do this), you will be taken to the dressing rooms and asked to change into a hospital gown and remove anything containing metal i.e. jewellery, watches. Some staff are nice enough that if you are wearing a vest top, jumper or some leggings without any traces of metal, they will allow you to wear it under the gown for some extra comfort.
Once you’re dressed, definitely take this time to use the loo while you have the chance! You will be given a bag to put your belongings and clothes in and these will be taken with you and left just outside the scan room, so you can rest easy knowing they are safe. Then you will be taken to get a canula fitted where you will also be given a wristband with your name and hospital number.
Procedure
From here you will be taken to the scan room. If you are over 18 you will likely be going it alone. You’re allowed to bring someone with you regardless of your age though, and this can be particularly useful if you are anxious or if you get claustrophobic. The same clothing/ no metal rules apply to whoever is going in with you though, even though they will be watching the scan from behind the glass screen with the doctors. Sometimes a sedative can also be given to calm particularly nervous patients before the scan, so speak to a doctor if you think you will need this.
Once in the scanning room you will be asked to lie face down on the scanning bed, usually with your arms above your head. The scanner looks pretty big and intimidating at first- kind of like an igloo I suppose. But once you’re lying down your nerves should settle. You will be given headphones to protect your ears from the noisy machine (seriously, it is REALLY loud in there!) and so that the doctors can give you breathing instructions during the scan. Some equipment will then be placed on your back and a buzzer will be placed in one of your hands in case you need assistance at any point. Then the external door will be sealed, and you will be moved into the centre of the scanner.
The scan should last around 40-odd minutes and don’t be alarmed by the banging/ clanking sounds! That isn’t a malfunction or a sign that the machine is about to blow up, as I said above the scanners are just very loud and tuneful! If you still feel a little nervous, just try and focus on the breathing instructions given via the headphones- its nothing too complicated, just holding your breath for 10-20 seconds to get a nice clear picture.
Now, one thing I have to say is that your arms will probably go numb at one point. 40 minutes is a long time and your arms are usually suspended above your head and on top of several cushions. I would just recommend trying to subtly move them to regain circulation if this happens! Then in the last 10 minutes or so of your scan, a doctor will come in and give you the dye injections you previously consented to through your canula. You may also be given another injection of Buscopan, an agent which will relax your abdomen even more in addition to the lactulose you drank earlier. You may get a little dizzy for a couple of minutes after these injections, but it fades quickly.
After the procedure
So that’s it really! After the scan, you will be lowered out of the machine and your canula will be removed by one of the doctors before you are allowed to go and get dressed again. It is not recommended that you drive after the scan, so either arrange for someone to come with you or hang around in the hospital for a bit. I generally do this as a precaution anyway as you will likely need the loo… a lot. Try not to eat anything which will aggravate the problem either, I usually stick to plain foods for at least the rest of the day to try and settle my stomach. It’s also natural to feel very bloated after drinking all that water on an empty stomach, but this should settle the next day. Usually the effects of the lactulose completely wear off in around 2-3 days after the scan, but this may vary depending on whether you are ill or in remission. The results should be sent to your IBD doctor and you should receive them in a week or two.
Extra tips
- I would advise bringing some spare underwear with you for after the scan- just in case!
- Wear clothes that are not too tight, you’ll be very bloated and uncomfortable for a while afterwards and your tummy will be tender- wearing paint-on jeans certainly won’t help!
- Also, don’t bother wearing any jewellery as you will just have to remove it and it can be a pain finding somewhere to put it without it getting lost amongst your other belongings
- If you get any say in when you would like your appointment to be, always opt for the earliest morning slot available, that way you won’t have to make a concerted effort to fast beforehand as the work will be done over night while you’re asleep 😊
- Some doctors allow you to listen to music during the scan via the headphones they provide, so if your doctor seems nice you may as well ask! I have listened to anything from 80s playlists to the UK top 40 during scans in the past!
- If you get cold easily or you know that your scan will be done in a mobile unit rather than an actual hospital department, make sure you wear or bring leggings/ a top or jumper without any metal to wear under your gown- the mobile units are FREEZING.
- Make sure you wear/ bring socks as you may have to walk around bare foot otherwise (ew…)
- And of course, don’t forget to bring some squash or something to flavour your lactulose and water- it really helps!
Me and My Crohn's 