Barium enema is an imaging procedure, performed for examining the large intestine. Medically referred to as lower gastrointestinal (GI) series, it is an out patient procedure, conducted as a part of routine medical checkups. The principle behind the procedure is to create a contrast in the bowel by using barium, so that the particular portion can be captured by normal X-ray imaging. This particular diagnostic test is effective for identifying bowel problems, and other diseases that affect the lower gastrointestinal tract.
This procedure is performed in a radiology clinic or hospital, usually by a radiotherapist. As the large intestine (including colon and rectum) is filled with air, X-ray passes through it easily. However, the outcome would be a plain picture, without any clear results. In order to solve this problem, a contrast is created by using enema solution (barium), after which the imaging test is done. Prior to this procedure, certain preparatory steps would be required to get accurate results.
Preparation for the Test
An essential condition for this procedure is to empty the colon as there would be chances of getting the wrong results. Hence, the individual undergoing this procedure should cooperate and follow the proper steps of preparation, as directed by the radiologist. Prior to the procedure, the doctor would examine the medical history and allergic reactions (if any) of the affected individual. On examining, if everything is fine, then the individual would be asked not to eat or drink anything after midnight, on the day that the test would be conducted. One may be asked to follow a special diet that would include only clear liquids such as plain water, clear tea or coffee (without milk or cream), strained fruit juices, clear carbonated beverages, etc. for 1 to 3 days before the test. Along with this, laxatives or enema may also be used, in order to empty the bowels. In case of issues regarding the intake of certain medications before the procedure, it would be necessary to follow the guidelines as directed by the concerned doctor.
According to the procedure, there are two types of barium enema, namely, single-contrast and double-contrast. In the former case, barium is introduced in the bowel, after which X-ray is taken directly. In double-contrast GI series, barium is filled in the bowel and then emptied. Following this, the portion is filled with air, delivered externally. In comparison to single type, the double contrast procedure provides detailed pictures of the intestinal lining. However, the doctor would recommend the best procedure, based on the current condition of the individual.
Once in the clinic or hospital, the individual would lie flat on the back on the X-ray table. A normal imaging test is done before the actual procedure. Then, lying the individual on one side, the radiologist would introduce a lubricated enema tube in the rectum, which in turn is attached to a bag containing barium. The balloon of the tube is inflated gently, and barium flows into the bowel of the individual. It is not unusual to feel fullness, mild discomfort, abdominal cramp, or an urge to defecate as soon as barium fills up the bowel.
Barium, being a white liquid, does not allow radiation to pass through, thus, making the bowel visible in X-ray. During the delivery of barium, the doctor would closely monitor the flow with the help of a fluoroscope. Then, the X-ray images are taken from various angles. Following this, the enema tube would be removed from the rectum. This procedure generally lasts for 30 - 60 minutes. After the test, passing out whitish stools is normal and may last for two days. The doctor may ask to drink ample amounts of water and juice to flush out barium.
The procedure result is then analyzed by the concerned physician. Any medical condition related to the intestinal lining, such as diverticulitis, polyps, ulcer, severe inflammation, colon cancer, and rectum cancer can be identified from the test result. If at all, a candidate is not fit for this procedure, the doctor would recommend magnetic resonance imaging (MRI) and computed tomography (CT) tests.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.