This topic is about managing breast cancer treatment and imaging procedures for someone who has an ileostomy. A 53-year-old woman, who has had an ileostomy since 1996 due to ulcerative colitis, is now dealing with breast cancer treatment after a successful lumpectomy. She is concerned about how chemotherapy, medication, and radiation therapy might affect her ileostomy, as well as the implications of upcoming CT imaging. Here are some helpful insights and advice:

1. Safety of CT, MRI, and PET Scans with an Ileostomy
- Many people with ileostomies have regular CT scans, often with oral contrast and IV dye, as well as MRI or PET exams, without any issues affecting their stoma.
- The scanning process is quick, and you might feel a brief sensation of warmth after the IV contrast.
- It's a good idea to eat lightly before the scan and drink plenty of fluids afterward to keep the output thin and prevent dehydration.

2. Alternatives to Oral Contrast
- Some surgeons now avoid using barium for patients with ostomies, opting for plain water or a water-soluble agent instead.
- Alternatives include plain water or Gastrografin, which is an iodinated, water-soluble contrast.
- If barium must be used, medical staff can flush the intestine immediately afterward. Since output starts almost immediately, the risk of blockage is low but should still be monitored.

3. Chemotherapy Experience with an Ileostomy
- People who have undergone full courses of chemotherapy for breast or colon cancer report no changes in stoma function, only experiencing typical side effects like tingling in the extremities.
- It's important to maintain fluid intake and monitor electrolytes, especially potassium and sodium, to prevent dehydration from potential nausea or diarrhea.

4. Observations on Radiation Therapy
- One person completed both chemotherapy and localized breast radiation without any complications related to their ostomy. Staying hydrated and monitoring electrolytes were crucial precautions.

5. General Tips
- Inform your radiology and oncology teams about your ileostomy; they are accustomed to accommodating ostomy patients.
- Avoid large, high-fiber meals before imaging and gradually return to your normal diet afterward.
- Keep emergency supplies on hand in case increased output requires an unscheduled pouch change.