A barium enema, or lower gastrointestinal (GI) examination, is an X-ray examination of the large intestine (colon and rectum). The test is used to help diagnose diseases and other problems that affect the large intestine. To make the intestine visible on an X-ray picture, the colon is filled with a contrast material containing barium. This is done by pouring the contrast material through a tube inserted into the anus. The barium blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray picture.
There are two types of barium enemas:
Why barium enema is performed?
- In a single-contrast study, the colon is filled with barium, which outlines the intestine and reveals large abnormalities.
- In a double-contrast or air-contrast study, the colon is first filled with barium and then the barium is drained out, leaving only a thin layer of barium on the wall of the colon. The colon is then filled with air. This provides a detailed view of the inner surface of the colon, making it easier to see narrowed areas (strictures), diverticula, or inflammation.
A barium enema is done to:
How barium enema is performed?
- Identify inflammation of the intestinal wall that occurs in inflammatory bowel diseases, such as ulcerative colitis or Crohn's disease. A barium enema also may be used to monitor the progress of these diseases.
- Find problems with the structure of the large intestine, such as narrowed areas (strictures) or pockets or sacs (diverticula) in the intestinal wall.
- Help correct a condition in which the end of a child's small intestine protrudes into the large intestine.
- Evaluate abdominal symptoms such as pain, blood in stool, or altered bowel habits.
- Evaluate other problems such as anaemia or unexplained weight loss.
To make the intestine visible on an X-ray picture, the colon is filled with a contrast material containing barium. This is done by pouring the contrast material through a tube inserted into the anus. The barium blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray picture.
- You will lie on the X-ray table while a preliminary X-ray film is taken.
- While you are lying on your side, a well-lubricated enema tube will be inserted gently into your rectum. The barium contrast material is then allowed to flow slowly into your colon.
- A small balloon on the enema tip may be inflated to help you hold in the barium. Tightening your anal sphincter muscle (as if you were trying to hold back a bowel movement) against the tube and taking slow, deep breaths may also help.
- Occasionally, you may be given an injection of medicine to relieve the cramping.
Your doctor will observe the flow of the barium through your colon on an X-ray fluoroscope monitor that is similar to a television screen.
- You will be asked to turn to different positions, and the table may be tilted slightly to help the barium flow through your colon and to take X-rays from different directions (sides, front, and back).
- Your doctor may also press gently on your abdomen with his or her hand or a plastic paddle to help move the barium through your intestines.
- If a double-contrast study is being done, the barium will be drained out and your colon will be filled with air.
A single-contrast study usually takes 30 to 45 minutes, although the actual time the barium is held inside is only 10 to 15 minutes. A double- or air-contrast study may take up to an hour.
After the test, you may resume your regular diet
unless otherwise instructed. Be sure to drink plenty of liquids to replace those you have lost and to help flush the remaining barium out of your system. Your bowel movements may look white or pinkish for 1 to 2 days after the test. Your doctor may recommend you take a medicine, such as a laxative, to help you pass the rest of the barium.
Risks associated with barium enema
- Occasionally the barium remaining in the colon hardens, causing severe constipation (impaction) or obstruction. To decrease the risk of impaction, drink extra fluids following the procedure and, if your doctor recommends it, take an enema or mild laxative after the test.
- In rare cases, barium can cause inflamed areas in the colon.
- Perforation of the bowel is a more serious, but very rare complication.
Call your gastroenterologist immediately if you: