Oral Cholecystogram Procedure and Risks

Oral cholecystogram is an X-ray examination of the gallbladder. The gallbladder is an organ located in the upper right-hand side of your abdominal cavity. Your gallbladder stores bile, a fluid that aids digestion.

“Oral” refers to the oral medication you take before the test. The medication is an iodine-based contrast agent that makes your gallbladder more clearly visible on the X-ray.

Oral cholecystogram is used to diagnose problems related to the gallbladder. The X-ray can show inflammation of the organ, and other abnormalities like polyps, tumors, and gallstones.

Preparing for Oral Cholecystogram

Preparing for oral cholecystogram is a multistep process.

Two days before the test, you can eat normal meals. Some doctors might suggest eating a high-fat meal for breakfast or lunch, including fatty meats and cheese, whole milk products, or eggs.

Bile helps you digest fats, and eating more fats than normal may help your doctor identify problems more easily. Other doctors might ask you to follow your normal diet during this time period. Follow your doctor’s directions closely to ensure accuracy of the test.

On the day before the oral cholecystogram, follow a low-fat diet. Lean meats such as chicken or fish, vegetables, fruits, bread, and skim milk are ideal choices.

The evening before the test, you will take the contrast agent medication. The medication is available in pill form. You will take a total of six pills that night, one each hour. Your doctor will tell you what time to take the first pill. Take each dose of medication with a full glass of water.

Do not eat anything else after you have started to take the contrast agent.

The morning of your oral cholecystogram, do not eat or drink anything. Ask your doctor ahead of time if you are allowed to take routine medications, or if you must skip your dose.

If you have completed other gastrointestinal testing in the few days before your oral cholecystogram, your doctor may recommend an enema or laxative to clear your digestive tract.

The contrast agents used in certain tests, such as an upper gastrointestinal (GI) series or barium enema, can obscure your gallbladder. Clearing your bowels makes your gallbladder more visible.

Oral Cholecystogram Procedure

Oral cholecystogram is performed as an outpatient procedure while you are awake. You will be able to see what the doctor looks at on a monitor, and can go home after the procedure.

The doctor will have you lie down on an exam table. Then, he or she will use an X-ray camera called a fluoroscope to see your gallbladder. X-ray pictures will be taken throughout the examination.

You might be given a special drink that is high in fat to stimulate your gallbladder to release bile, which can help your doctor identify problems.

Oral cholecystogram is painless. However, you might experience diarrhea and stomach cramping due to the contrast agent.

The test is done in a hospital radiology department or in the health care provider’s office by an x-ray technician. The night before the test, you swallow six tablets (one at a time). These tablets contain a special dye (contrast medium) that helps the gallbladder show up better on the images.

At the hospital, you will lie on the x-ray table and will be asked to change position from time to time.

The health care provider may look at your gallbladder with a fluoroscope, an x-ray that can be immediately seen on a TV-like monitor.

Then you may be asked to drink a high-fat liquid that will cause the gallbladder to contract and release some bile. X-ray images will be taken at timed intervals.

Risks associated with oral cholecystogram are uncommon. Those who experience problems usually display a mild allergic reaction to the contrast agent. Symptoms can include:

  • rash
  • itching
  • nausea

Breathing difficulties and swelling of the face or mouth can indicate a serious allergic reaction called anaphylaxis. Anaphylaxis can be life threatening if not treated.

Notify your healthcare provider immediately if you experience wheezing, shortness of breath, or facial swelling after taking the preparatory medication.

The exposure to radiation during oral cholecystogram is low. If you are pregnant, discuss this with your doctor before the test. Although the radiation exposure is minimal, it may not be safe for your unborn child.

How the Test Will Feel

There is little or no discomfort from the test, although you will probably be hungry and thirsty. Some people experience side effects from the contrast material. There is a slight chance of developing diarrhea.

Why the Test Is Performed

The test is used to help diagnose disorders of the liver and gallbladder, especially gallstones. For most purposes, it has been replaced by other tests, such as abdominal ultrasound or gallbladder radionuclide scan.

What Abnormal Results Mean

  • Cholesterol polyps (noncancerous growths)
  • Gallstones
  • Inflammation
  • Tumors

Results and Recovery

Your healthcare provider will notify you of the results of the test and any treatments that may follow.

Benign polyps on the gallbladder and small gallstones may not require any further treatment.

Cancerous growths and gallstones that cause pain will be treated through medications or surgery.


Ultrasound and MRI examination of the gallbladder has largely replaced the use of oral cholecystogram, especially in patients with diseased livers. Another type of scan (a nuclear medicine HIDA scan) may be used to see how the gallbladder works.

Source & More Info: NY Times and Healthline



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