This information leaflet has been produced to give you general information and hopes to answer most of your questions about a colonic stent. It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
Why do I need this procedure?
The bowel is the passage that takes waste from the body. If it becomes narrow then there can be a problem passing stool. Your doctor has discovered that you have a narrowed area in your bowel. If you have this procedure performed then it can help open your bowels.
What are the benefits of the procedure?
To enable you to pass stool more easily and reduce any symptoms caused by the narrowing of the bowel.
How do I know if this is a suitable procedure for me?
Your doctor has suggested this as the most suitable treatment for you.
Can I take my medication as normal?
If you take Warfarin or other blood thinning medication such as Aspirin, Rixaroxiban or Clopidogrel then this should be stopped before the procedure. You will receive advice about when to stop your blood thinning medication from the hospital; do not stop these without these instructions. All other medication can be taken as normal.
Is there any preparation for the procedure?
If you are not already an inpatient you will be admitted to a ward. Before you can have the procedure you will need to have an enema, (this means passing some liquid into your back passage which will help to clear any stool from your bowel to make the procedure simpler to perform). You will also be given some antibiotics in the form of a suppository that is placed into your back passage.
You will be asked to change into a hospital gown and a plastic needle will be placed into a vein in your hand or arm.
The nurse will ask you a series of questions on a checklist before you leave the ward.
What happens during the procedure?
On arrival in the department
You will be met by a radiology nurse and a radiographer who will check your details and run through the safety questions on the checklist again with you. The radiologist (Doctor who specialises in performing procedures using x-rays) will talk to you about the procedure and ask your permission to go ahead; your signature will be required on a consent form to confirm this.
We can give you sedation if necessary but this procedure is rarely painful. It is often best to be awake so that you can change position during the procedure easily. We use jelly containing local anaesthetic around your back passage to keep you comfortable.
During the procedure
You will be asked to lie on the x-ray table, on your left side. You will have three small sticky pads stuck to your chest to attach to a monitor so that the nurses can record your heart rate, your blood pressure will be recorded regularly and a probe will be attached to your finger to monitor your oxygen levels. You may receive oxygen during the procedure.
The radiologist will pass a soft tube into your back passage and run in some watery fluid. The fluid contains Iodine which is visible on x-ray. It helps to identify the precise level of narrowing (stricture) and indicate where the stent needs to be placed.
We will ask you to hold in the fluid for a few minutes whilst we take x-ray images. The fluid will then be drained off immediately and the tube removed.
A smaller catheter (hollow tube) is now passed into the bowel through your back passage and guided to the narrowed or blocked area over a guidewire. Once a guidewire crosses the stricture another catheter, containing the stent, will slide over the wire. The stent is collapsed down by a smooth external sleeve. Once the stent is correctly placed, the sleeve slides back and the stent is released. It expands automatically and will gradually stretch up the stricture over 48 hours.
When the stent position is confirmed, all the tubing and the guide wire are removed.
At the end of the procedure
After the examination you will be helped back to a trolley to be escorted back to the ward by a qualified nurse and will need to rest in bed for about three hours. The nursing staff will check your blood pressure and pulse regularly whilst you are on the ward. You will be seen by a member of medical staff before you are discharged home and may require another x-ray the following morning to check that the stent has opened fully. It is normal to be in hospital overnight after colonic stenting.
Are there any risks?
Minor
There is a small risk that a little bleeding will occur during the procedure. This will normally stop without the need for any action.
Major
- Following stent placement there is a possibility that your bowel may be torn by the stent or become leaky. The chance of this happening is one in 20. This is a very serious problem which may be fatal or require urgent surgery. The nurses on the wards will monitor you regularly following stent placement to help identify significant complications. An x-ray is taken the following day to confirm the position of the stent and look for signs of a leak.
- In one in 10 patients the stent may become blocked, this can usually be treated successfully with another stent.
- In a further one in 10 patients the stents position may move so that it is no longer effective. Again this is usually treated successfully with another stenting procedure.
- In a small number of patients the procedure cannot be completed and this usually means that surgery is required.
How soon will I be back to normal?
We usually require patients to stay overnight in hospital after a colonic stent. When we are certain the stent is working and there have been no complications you will be discharged. If you have been unable to pass stool for a while it may take longer to recover. You may need help with stool softeners for instance.
If you don’t think you are improving after discharge, it is important to get in touch quickly so we can reassess your condition.
If you had to stop any medication for this procedure the ward nurses will advise you on restarting these.
What happens if I decide not to have the procedure?
You will be referred back to the doctor who recommended the colonic stent to consider alternative treatment.
What if I have any special requirements?
If you have any special needs or requirements please contact the x-ray staff on the number below.
Where can I get more information?
Please contact the x-ray department:
Monday to Friday (9am to 5pm) 0191 445 3260
NHS 111