Barium Enema

Everyone should know that a lower GI is a very common and important exam used to diagnose many colon conditions. A lower GI examination, also know as a barium enema, is an x-ray examination of the large intestine. The large intestine, or large bowel, consists of the entire colon, including the appendix, rectum, and sigmoid colon. This commonly performed test is essentially the predecessor to the more familiar colonoscopy. A lower GI is used worldwide to help diagnose fatal diseases and many other problems that affect the large intestine.

Some of the reasons that your doctor might order this exam are if you are experiencing diarrhea, constipation, blood in your stool, unexplained weight loss, anemia, to screen for colon polyps or colorectal cancer. Because this test demonstrates the large bowel, it is imperative to clean out the bowel completely. The smallest amount of stool left in the intestine can affect the accuracy of the test. To ensure the colon is cleaned the patient is instructed to be on a clear liquid diet for 24 hours prior to the exam. They are also instructed to take a strong laxative the day before. Most patients say that the preparation for the exam is the worst part. Before the test is started an x-ray of the abdomen is taken to check for residual stool and gas. If there is too much stool remaining in the bowel, the patient will have to be rescheduled, and take the laxative prep again.

A barium enema test is done by a radiologist and one or two radiographers, or x-ray techs. After the preliminary x-ray, an enema tip is inserted into the rectum. After the tip is in place and your body adjusts to it, a small balloon is then inflated to help hold in the barium and keeps the tip in the rectum. The barium is then released from the bag and begins to flow slowly into your colon. As the barium begins to fill your bowel you will feel some pain and pressure, and an urgency to have a bowel movement. The doctor will watch the barium as it moves through your intestine on a TV screen, using a special “live x-ray” called fluoroscopy. You will be asked to turn to different positions, and the table may be tilted slightly to help the barium flow through your colon and to take x-rays from different directions. Sometimes a slightly different version of the test may be done. It is called a double contrast barium enema. If a double contrast study is being done, the barium will be drained out, and then air will be injected into your colon. As you can imagine with the air contrast study, the amount of cramping and pain increases, due to the expansion of the bowel with air. After all of the films are taken the enema tube is removed, and you are taken to the restroom to expel the remaining barium and air. One or two films may be taken afterwards, to check how much barium is remaining in your bowel. The entire test takes anywhere from thirty minutes