An oral cholecystogram is an X-ray examination of your gallbladder. Your gallbladder is an organ located in the upper right-hand side of your abdominal cavity, just underneath your liver. It stores bile, a fluid produced by your liver that aids in digestion and absorption of fats from your diet.

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.

This procedure is now rarely performed since the first-line method for imaging of your gallbladder is an abdominal ultrasound or CT scan typically followed by a hepatobiliary scan or endoscopic retrograde cholangiopancreatography. These tend to be more accurate when it comes to diagnosis of gallbladder conditions.

The oral cholecystogram study is used to diagnose problems related to your gallbladder, such as gallbladder cancer or decreased or blocked bile flow in the biliary duct system of your liver.

The X-ray can show inflammation of the organ, a condition known as cholecystitis. It can also reveal other abnormalities such as polyps and gallstones.

Preparing for oral cholecystogram is a multistep process.

What to eat two up to two days before

Two days before the test, you generally can eat normal meals. If instructed otherwise, follow your doctor’s directions closely to ensure accurate test results.

What to eat the day before

Follow a low-fat or fat-free diet the day before the procedure. Ideal choices include:

  • chicken
  • fish
  • vegetables
  • fruits
  • bread
  • skim milk

Taking the contrast medication before the test

The evening of the day before the test, you’ll take the contrast agent medication. The medication is available in pill form. You’ll take a total of six pills, one each hour. Your doctor will tell you what time to start taking the first pill.

Take each dose of medication with a full glass of water. On the evening before the test, don’t eat any solid foods after you’ve started taking the contrast agent. Drinking water is fine until midnight. By then, you should be fully fasting. You should also refrain from smoking cigarettes or chewing gum.

What to expect the morning of the oral cholecystogram

Don’t eat or drink anything the morning of your procedure. Ask your doctor ahead of time if you’re allowed to take routine medications, or if you should skip it. You may be able to take a few sips of water, but be sure to ask your doctor first.

If you’ve completed certain types of gastrointestinal imaging in the few days before your oral cholecystogram, your doctor may recommend a rectal laxative, or enema, to clear your bowels.

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

Oral cholecystogram can be performed as an outpatient procedure while you’re awake. You might be given a special high-fat drink to stimulate your gallbladder to contract and release bile, which can help your doctor identify problems.

The doctor will likely have you lie down on an exam table, but you may be asked to stand. This depends on the what views of your gallbladder are required. Then, they’ll use an X-ray camera called a fluoroscope to see your gallbladder. You may be able to see what the doctor is seeing on a monitor, depending on the room setup. Your doctor will take X-rays throughout the examination.

Oral cholecystogram is painless. However, you might experience diarrhea, nausea, or stomach cramping due to the contrast agent. If done as an outpatient imaging study, typically you can go home after the procedure, as long as no complications arise.

Severe risks caused by oral cholecystogram are rare. Some people may experience mild temporary symptoms, such as:

Some people may also experience problems caused by an adverse reaction or mild allergic reaction to the contrast agent. Allergy or intolerance symptoms can include:

Learn more about iodine reactions.

If you have any allergies to preservatives, food dyes, or animals, let your doctor know prior to taking the contrast agent.

Breathing difficulties and swelling of your face or mouth can indicate a serious acute allergic reaction called anaphylaxis.

Anaphylaxis can be life-threatening if not treated. Notify your doctor immediately if you experience any of the following after taking the contrast medication:

If you’re pregnant, breastfeeding, or trying to become pregnant, talk to your doctor about this before undergoing this test. Although radiation exposure is generally considered lower with this test, it may not be safe for your unborn child. Additionally, the contrast medication used for this test should be avoided in pregnancy.

To avoid potential drug interactions, you should also let your doctor know of any prescription or over-the-counter medications you currently take.

People with certain types of medical conditions may not be candidates for this test. These include:

  • kidney disease
  • liver disease
  • other chronic conditions
  • severe adverse reaction to prior iodine contrast exposure

Your doctor will notify you of the results of the test and any treatments that may need to follow.

For example, cancerous growths and gallstones that cause pain or biliary dysfunction may be treated with medications or surgery. Benign polyps on your gallbladder and small gallstones may not require any further treatment.