Barium Enema Test and Procedure
Overview
A barium enema, also known as a lower gastrointestinal (GI) series, is a medical imaging test that uses X-rays to assess the large intestine. In this procedure, a healthcare provider fills the colon with a liquid containing barium through a small tube inserted into the rectum.
The barium coats the inner lining, allowing X-rays to capture clearer images. Sometimes, the provider introduces air into the colon after giving the barium. This combination, called a double-contrast barium enema, helps provide even more detailed images by spreading the barium more evenly.
Key Features:
- Examines the colon and rectum.
- Uses barium to outline the intestines.
- Incorporating air can enhance contrast significantly.
Doctors usually ask patients to empty their colon completely before the test to get the best possible results.
Reasons for Performing the Test
Doctors may order this procedure to find out what is causing symptoms such as ongoing stomach pain, changes in how the bowels work, rectal bleeding, constant diarrhea, or unexplained weight loss. Sometimes, they use it if other tests, like colonoscopy are not possible. Other purposes for this test include:
| Condition | Description |
|---|---|
| Colon polyps | Tissue growths in the colon. |
| Crohn’s disease | Ongoing swelling in the intestine. |
| Narrowed areas (strictures) | Places where the bowel becomes too tight. |
| Fistula | Abnormal connection between organs. |
| Ulcerative colitis | Swelling and sores in the colon. |
- Checking for abnormal growths called polyps.
- Looking for problems from inflammatory bowel disease.
- Identifying areas of strictures or constriction.
- Investigating fistulas.
This exam used to be common, but now other methods like CT scans are used more often because they give clearer results.
Possible Complications
A barium enema can cause a few uncommon problems, such as:
- Inflammation in tissue near the colon.
- Blockage in the digestive tract.
- A tear in the wall of the colon.
- Allergic reaction to the barium solution.
Doctors usually avoid this exam for pregnant women because X-rays can pose a risk to unborn babies.
How You Get Ready
To prepare for a barium enema, patients must clear their colon. This ensures that the X-ray images are accurate and not obscured by anything that might hide potential issues. Patients are usually advised to follow a few key steps to get ready:
- Change your diet. The day before the test, only clear liquids are allowed. This can include water, broth, plain tea or coffee (no milk or cream), sports drinks, and clear soda.
- No food or drink after midnight. Usually, nothing should be eaten or drunk after midnight before the test.
- Use a laxative. Take a laxative, either liquid or pill, the evening before the test to help clean out the colon.
- Enema option. Sometimes, use an over-the-counter enema to help remove any leftover waste in the colon. This could be used the night before or a few hours before the exam.
- Medical review. About a week ahead, talk to the doctor about any medicines you take. Some may need to be stopped for a few days before the test.
Tips for Success
| Step | What to do |
|---|---|
| Clear liquids | Drink as instructed. |
| Laxative/enema | Follow the schedule. |
| Check medication | Inform your doctor. |
What You Can Expect
While the Procedure Is Being Done
Staff will ask patients to remove any jewelry, glasses, or dental devices and change into a hospital gown. The medical team, which includes a radiologist and a technician, will guide patients through the process.
The patient starts by lying on their side on an X-ray table designed for this exam. The radiologist often takes an initial X-ray to check that the large intestine is clean. Next, the technician gently inserts a soft, lubricated tube into the rectum. This tube connects to a bag containing a barium solution.
- Single and Double-Contrast Exams:
- Single-Contrast: Staff use only barium to fill the colon.
- Double-Contrast (Air-Contrast): After the barium, they may add air to provide clearer X-ray images by expanding the colon.
The tube has a small balloon at the tip, which the technician inflates once it’s in place. This helps keep the barium inside the colon. As the barium moves through the colon and large intestine, the patient may feel an urge to use the toilet or experience mild cramping.
Deep breathing can help manage these sensations. During the test, staff may ask the patient to change positions on the table. This helps the barium coat all surfaces and ensures the radiologist gets complete images of the colon from different angles.
The radiologist might also gently press on the abdomen or pelvis to help distribute the barium more evenly. The radiologist takes X-ray images at multiple stages of the exam. This examination usually takes between 30 to 60 minutes.
| Step | What Happens |
|---|---|
| Preparation | Change clothes and remove metal items. |
| Initial Positioning | Lie on your side on the X-ray table. |
| Insertion | Lubricated tube placed in the rectum. |
| Filling | Barium and sometimes air introduced into the colon. |
| Position Changes | Patient turns as directed for various X-rays. |
| Imaging | Radiologists take X-rays from multiple angles. |
What Happens After the Test
When the exam ends, the technician will drain most of the barium out through the enema tube. After the tube is removed, patients can use the restroom to pass any remaining barium and air. Most people find that any stomach cramps fade quickly and can usually return to normal foods and activities soon after leaving the clinic.
It’s normal for the stool to appear white or light-colored for a few days due to the barium. Some people may also feel constipated afterward. Drinking plenty of fluids can help move the barium out of the system. If needed, a doctor may recommend a mild laxative.
- Key Tips After the Test:
- Increase fluid intake for several days.
- Eat as usual unless the doctor gives other instructions.
- Monitor for difficulty passing stool or gas.
If a patient cannot have a bowel movement or pass gas within two days, or if the stool color does not return to normal after several days, they should contact their healthcare provider for advice.
What the Test Shows
After the barium enema exam, the radiologist reviews the images and prepares a report for the doctor. Results are usually described as either normal or abnormal:
| Result Type | Description | Next Steps |
|---|---|---|
| Negative | No unusual findings in the colon. | No extra testing is usually needed. |
| Positive | Issues detected, like unusual shapes, blockages, or growths. | More tests, such as a colonoscopy, might follow. |
If the images are unclear, the doctor may repeat the test or choose a different method to gather better information. The doctor will then review the results with the patient and discuss any necessary next steps.
