A barium enema, or lower gastrointestinal (GI) examination, is an X-ray examination of the large intestine (colon and rectum). The test is used to help diagnose diseases and other problems that affect the large intestine. To make the intestine visible on an X-ray picture, the colon is filled with a contrast material containing barium. This is done by pouring the contrast material through a tube inserted into the anus. The barium blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray picture.
There are two types of barium enemas.
In some cases, the single-contrast study may be preferred for specific medical reasons or for older people who may not be able to tolerate the time-consuming and somewhat more uncomfortable double-contrast study. But if the results are not clear, a double-contrast study may also be done.
A barium enema is done to:
Before a barium enema, tell your doctor if you:
The preparation for a barium enema usually involves a very thorough cleansing of the large intestine, because the colon must be completely clear of stool and gas. Even a small amount of stool can affect the accuracy of the test.
Talk to your doctor about any concerns you have regarding the need for this test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).
To make the intestine visible on an X-ray picture, the colon is filled with a contrast material containing barium. This is done by pouring the contrast material through a tube inserted into the anus. The barium blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray picture.
Your doctor will observe the flow of the barium through your colon on an X-ray fluoroscope monitor that is similar to a television screen.
When the test is finished:
A single-contrast study usually takes 30 to 45 minutes, although the actual time the barium is held inside is only 10 to 15 minutes. A double- or air-contrast study may take up to an hour.
After the test, you may resume your regular diet unless otherwise instructed. Be sure to drink plenty of liquids to replace those you have lost and to help flush the remaining barium out of your system. Your bowel movements may look white or pinkish for 1 to 2 days after the test. Your doctor may recommend you take a medicine, such as a laxative, to help you pass the rest of the barium.
A barium enema procedure can be uncomfortable and tiring, but usually it does not last very long.
Many people report that the preparation and bowel cleaning are the hardest parts of the test. The laxative may have an unpleasant taste, and the frequent bowel movements can be tiring. Also, the anal area can become quite sore during the process. Warm sitz baths or a local anesthetic salve, such as Preparation H, can help ease this discomfort.
You may be embarrassed by the test. You may worry that you won't be able to hold the barium and that it will leak onto you or onto the table. The doctors who perform this procedure are accustomed to this and will be able to help you.
The X-ray table is hard and sometimes cold because air-conditioning is used to keep the equipment cool. When the barium first flows into your colon, it may feel a bit cool. As your colon fills, you may feel a sensation of fullness, moderate cramping, and a strong urge to have a bowel movement. If an air-contrast study is performed, you may feel increased cramping or gas pains from having gas pumped into your large intestine. Taking slow, deep breaths through your mouth can help you relax.
The test may take awhile, so you may want to bring something to do quietly (like a book or magazine to read).
You may feel tired for a day or so after the test. You should arrange for someone to drive you home after the test. This test can be exhausting.
There is very little risk of complications from having a barium enema.
Call your doctor immediately if you:
The results of a barium enema are usually available immediately after the test or within a few days.
The colon appears normal. See a picture of a barium enema X-ray.
One or more problems in the colon are detected, such as:
Many conditions can change barium enema test results. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.
Reasons you may not be able to have the test or why the results may not be helpful include:
Other Works Consulted
- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology|
|Last Revised||June 21, 2011|
Last Revised: April 21, 2012
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