Barium Enema

This is an x-ray evaluation of the large intestine, also known as the colon. The appendix may be seen if it is present and a portion of the small intestine may be visualized as well. Though still x-ray images can be useful in examining the colon and rectum, dynamic fluoroscopy is often the most effective way to view abnormal or blocked movement of waste through the body's lower gastrointestinal (GI) tract.

A physician may order a lower GI examination to look for ulcers, benign tumors (or polyps), inflammatory diseases, cancer or signs of certain other intestinal illnesses. The procedure is frequently performed on individuals suffering from chronic diarrhea, blood in stools, constipation, irritable bowel syndrome, unexplained weight loss, a change in bowel habits or to detect a source of suspected blood loss. Images of the bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.

What to expect with your procedure

You should tell your doctor about any recent illnesses or other medical conditions as well as any allergies you might have to medications. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant.

During the day before the procedure you will likely be asked not to eat, and to drink only clear liquids like juice, tea, black coffee, cola or broth, and to avoid dairy products. After midnight, you should take nothing by mouth. You may also be instructed to take a laxative (in either pill or liquid form) and to use an over-the-counter enema preparation the evening, or even a few hours before the procedure. It is permissible to take usual prescribed oral medication with limited amounts of water.
Once you arrive at the imaging center, you will be asked to change into a gown before your examination. You may also be asked to remove jewelry, eyeglasses or any metal objects that could obscure the images.

Preparing for your procedure

The lower GI exam is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.

The patient is positioned on the examination table and an x-ray film is taken to ensure the bowel is clean. The radiologist or technologist will then insert a small tube into the rectum and begin to pump a mixture of barium and water into the colon. Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon.
As the barium fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure or even minor cramping. Most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the technologist know.

During the imaging process, you will be asked to turn from side to side and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel, the table may be turned into an upright position.

You can resume a regular diet and take orally administered medications unless told otherwise by your doctor.  You will be able to return to a normal diet and activities immediately after the exam. You will be encouraged to drink additional water for 24 hours after the examination.

Your stools may appear white for a day or so as your body clears the metallic liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need an enema or laxative to assist in eliminating the barium.