Barium Enema Exam

A physician may order a barium enema to examine the colon and aid in the diagnosis of certain conditions, such as inflammatory bowel disease or polyps.

Common signs and symptoms that might require a barium enema include:

• Rectal bleeding
• Chronic diarrhea
• Chronic constipation
• Change in bowel movements
• Abdominal pain
• Bloody stool
• Sudden weight loss

Common conditions that might require a barium enema include:

• Crohn's disease
• Ulcerative colitis
• Colon cancer
• Irritable bowel syndrome (IBS)
• Diverticulitis/Diverticulosis

Your doctor will provide you with instructions for preparing for the examination, but the preparation will include:

• Disclose all medications: Provide a list of medications to your doctor at least a few weeks before the exam. Your physician will advise you on whether to continue or stop the medication for the procedure.
• Follow a special low-residue diet: Two or three days before the exam, you will be instructed to eat a low-residue diet consisting of liquids, low-fat, and finely crushed foods.
• No food after midnight: You will be asked to drink only clear liquids the night before the exam and to refrain from drinking or eating anything after midnight the night before the exam. Clear liquids include water, sprite, broth, white grape juice, and flavored water with no red or purple dye.
• Take a strong laxative: Your doctor will prescribe a strong laxative to clear your lower tract the day before the exam. For the exam to be successful, your lower digestive tract must be completely empty. Any residue will show up on the images and could be mistaken for an abnormality in the colon or rectum, which is why following the instructions given by your physician’s office is very important, especially the clear liquids instruction. If preparation is incorrectly followed, your exam will be rescheduled so that proper preparation can take place.
• Arrive 30 minutes prior: Please report to registration 30 minutes before your scheduled exam.

A radiologist or the radiology physician's assistant performs the barium enema test. These professionals specialize in the study of imaging tests, such as ultrasound and X-ray images, to assure the most accurate results for your exam.

• When you arrive for your test, you will change into a hospital gown.
• Your technologist will gently position you on a special tilting table attached to a fluoroscope (an X-ray machine combined with a television screen).
• As you lie on your side, a lubricated enema tip will be inserted into your rectum, and a liquid barium mixture will be released. The barium mixture will be observed on the television screen as it flows through your colon. (For air contrast (double contrast) barium enemas, air will also be released into the colon along with the barium).
• As the barium fills your colon, you may feel like you need to move your bowel. Let the technologist know if you are having trouble holding the barium.
• You will be asked to turn from side to side and hold several different positions.
• After the series of barium enema x-ray images are completed, you will go to the bathroom to expel the barium, and an additional image will be taken after the barium has been expelled.

Post barium enema procedure, you may be free to return to your normal activities and usual diet unless told otherwise by your physician. It is normal for the barium to give a whitish color to your stool for a day or two.

• Barium may cause constipation, so you will need to increase your water intake and possibly take a mild laxative. If you have trouble with constipation normally, you should consult your physician, as they may be able to prescribe a stool softener or other aids.
• If you experience side effects including rectal bleeding, pain, or fever, consult your physician right away.

The risks involved with a barium enema are far outweighed by the benefit of having a proper diagnosis and treatment plan afterward. The levels of radiation absorbed from an x-ray are very low and are comparable to the security screening when flying. Some risks of a barium enema include:

• An allergic reaction to the barium contrast dye
• A tear in the wall of the colon
• Inflammation of tissue in the colon
• A bowel obstruction

For the exam to be successful, your lower digestive tract must be completely empty. Any residue will show up on the images and could be mistaken for an abnormality in the colon or rectum, which is why following the instructions given by your physician’s office is very important, especially the clear liquids instruction.

If preparation is incorrectly followed, your exam will be rescheduled so that proper preparation can take place.

Inform the technologist if you may be pregnant. If there is a possibility of pregnancy, a pregnancy test will be ordered before the exam.