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Barium enema
Lower gastrointestinal series; Lower GI series; Colorectal cancer - lower GI series; Colorectal cancer - barium enema; Crohn disease - lower GI series; Crohn disease - barium enema; Intestinal blockage - lower GI series; Intestinal blockage - barium enema
Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.
x-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray particles through the body. The im...
How the Test is Performed
This test may be done in a doctor's office or hospital radiology department. It is done after your colon is completely empty and clean. Your doctor will give you instructions for cleansing your colon.
During the test:
- You lie flat on your back on the x-ray table. An x-ray is taken.
- You then lie on your side. The health care provider gently inserts a well-lubricated tube (enema tube) into your rectum. The tube is connected to a bag that holds a liquid containing barium sulfate. This is a contrast material that highlights specific areas in the colon, creating a clear image.
- The barium flows into your colon. X-rays are taken. A small balloon at the tip of the enema tube may be inflated to help keep the barium inside your colon. The provider monitors the flow of the barium on an x-ray screen.
- Sometimes a small amount of air is delivered into the colon to expand it. This allows for even clearer images. This test is called a double contrast barium enema.
- You are asked to move into different positions. The table is slightly tipped to get different views. At certain times when the x-ray pictures are taken, you are told to hold your breath and be still for a few seconds so the images will not be blurry.
- The enema tube is removed after the x-rays are taken.
- You are then given a bedpan or helped to the toilet, so you can empty your bowels and remove as much of the barium as possible. Afterward, 1 or 2 more x-rays may be taken.
How to Prepare for the Test
Your bowels need to be completely empty for the exam. If they are not empty, the test may miss a problem in your large intestine.
You will be given instructions for cleansing your bowel using an enema or laxatives. This is also called bowel preparation. Follow the instructions exactly.
For 1 to 3 days before the test, you need to be on a clear liquid diet. Examples of clear liquids are:
- Clear coffee or tea
- Fat-free bouillon or broth
- Gelatin
- Sports drinks without added color
- Strained fruit juices
- Water
How the Test will Feel
When barium enters your colon, you may feel like you need to have a bowel movement. You may also have:
- A feeling of fullness
- Moderate to severe cramping
- General discomfort
Taking long, deep breaths may help you relax during the procedure.
It is normal for the stools to be white for a few days after this test. Drink extra fluids for 2 to 4 days. Ask your doctor about a laxative if you develop hard stools.
Why the Test is Performed
Barium enema is used to:
-
Detect or screen for
colon cancer
Colon cancer
Colon, or colorectal cancer, is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Other types of cancer can affect ...
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Diagnose or monitor
ulcerative colitis
or
Crohn disease
Ulcerative colitis
Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...
ImageRead Article Now Book Mark ArticleCrohn disease
Crohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...
ImageRead Article Now Book Mark Article - Diagnose the cause of blood in stools, diarrhea, or very hard stools (constipation)
The barium enema test is used much less often than in the past. Colonoscopy is done more often now.
Colonoscopy
A colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. The colonoscope has a sm...
Normal Results
Barium should fill the colon evenly, showing normal bowel shape and position and no blockages.
What Abnormal Results Mean
Abnormal test results may be a sign of:
-
Blockage of the large intestine (
Hirschsprung disease
)
Hirschsprung disease
Hirschsprung disease is a blockage of the large intestine. It occurs due to poor muscle movement in the bowel. It is a congenital condition, which ...
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- Cancer in the colon or rectum
-
Sliding of 1 part of the intestine into another (
intussusception
)
Intussusception
Intussusception is the sliding of one part of the intestine into another. This article focuses on intussusception in children.
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Small growths that stick out of the lining of the colon, called
polyps
Polyps
A colorectal polyp is a growth on the lining of the colon or rectum.
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Small, bulging sacs or pouches of the inner lining of the intestine, called
diverticulosis
Diverticulosis
Diverticula are small, bulging sacs or pouches that form on the inner wall of the intestine. Diverticulitis occurs when these pouches become inflame...
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Twisted loop of the bowel (
volvulus
)
Volvulus
A volvulus is a twisting of the intestine that can occur in childhood. It causes a blockage that may cut off blood flow. Part of the intestine may ...
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Risks
There is low radiation exposure. X-rays are monitored so that the smallest amount of radiation is used. Pregnant women and children are more sensitive to x-ray risks.
A rare, but serious, risk is a hole made in the colon (perforated colon) when the enema tube is inserted.
References
Boland GWL. Colon and appendix. In: Boland GWL, ed. Gastrointestinal Imaging: The Requisites . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 5.
Chernecky CC, Berger BJ. Barium enema. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures . 6th ed. Philadelphia, PA: Elsevier; 2013:183-185.
Taylor S, Plumb A. The large bowel. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging . 6th ed. Philadelphia, PA: Elsevier; 2015:chap 29.
-
Barium enema - illustration
The barium enema is a valuable diagnostic tool that helps detect abnormalities in the large intestine (colon). The barium enema, along with colonoscopy, remain standards in the diagnosis of colon cancer, ulcerative colitis, and other diseases of the colon.
Barium enema
illustration
-
Rectal cancer, X-ray - illustration
A barium enema in a patient with cancer of the rectum.
Rectal cancer, X-ray
illustration
-
Sigmoid colon cancer, X-ray - illustration
A barium enema in a patient with cancer of the large bowel (sigmoid area).
Sigmoid colon cancer, X-ray
illustration
-
Barium enema - illustration
A barium enema is performed to examine the walls of the colon. During the procedure, a well lubricated enema tube is inserted gently into the rectum. The barium, a radiopaque (shows up on X-ray) contrast medium, is then allowed to flow into the colon. The flow of the barium is monitored by the health care provider on an X-ray fluoroscope screen (like a TV monitor). The test is used to detect colon cancer. The barium enema may also be used to diagnose and evaluate the extent of inflammatory bowel diseases.
Barium enema
illustration
-
Barium enema - illustration
The barium enema is a valuable diagnostic tool that helps detect abnormalities in the large intestine (colon). The barium enema, along with colonoscopy, remain standards in the diagnosis of colon cancer, ulcerative colitis, and other diseases of the colon.
Barium enema
illustration
-
Rectal cancer, X-ray - illustration
A barium enema in a patient with cancer of the rectum.
Rectal cancer, X-ray
illustration
-
Sigmoid colon cancer, X-ray - illustration
A barium enema in a patient with cancer of the large bowel (sigmoid area).
Sigmoid colon cancer, X-ray
illustration
-
Barium enema - illustration
A barium enema is performed to examine the walls of the colon. During the procedure, a well lubricated enema tube is inserted gently into the rectum. The barium, a radiopaque (shows up on X-ray) contrast medium, is then allowed to flow into the colon. The flow of the barium is monitored by the health care provider on an X-ray fluoroscope screen (like a TV monitor). The test is used to detect colon cancer. The barium enema may also be used to diagnose and evaluate the extent of inflammatory bowel diseases.
Barium enema
illustration
Review Date: 1/28/2016
Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
