What is a Barium Enema?
Radiological images are created by passing small, highly controlled amounts of radiation through the body and capturing the resulting shadows and reflections on film. Most people are familiar with x-ray images, which produce a still picture of the body's internal organs. A similar imaging method, fluoroscopy, uses x-rays to capture a moving image of an organ while it is functioning. Though still x-ray images can be useful in examining the colon, and rectum, fluoroscopy is often the most effective way to view abnormal or blocked movement of waste through the body's lower gastrointestinal (GI) tract.
What are some common uses of the procedure?
A physician may order a lower GI examination to look for ulcers, benign tumors (polyps, for example), cancer, or signs of certain other medical conditions. The procedure is frequently performed on individuals suffering from chronic diarrhea, blood in stools, constipation, irritable bowel syndrome, unexplained weight loss, a change in bowel habits, or suspected blood loss. Images of the bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that include Crohn’s disease and ulcerative colitis.
How should I prepare for the procedure?
You should tell your doctor about any recent illnesses or other medical conditions, as well as any allergies you might have to medications. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant.
- Day before exam:
Eat light breakfast and lunch
3:00 P.M.- Drink 8 oz. of Magnesium Citrate
5:00 P.M.- Take 4 Bisacodyl Tablets
Dinner- Bouillon soup and plain jello
- Drink 8 ounces of water every hour from 3 P.M. until you go to bed.
- You may drink water the morning of your exam, but do not eat anything.
Once you arrive at a Methodist Diagnostic Center, you will be asked to change into a gown before your examination removing your underpants, jewelry, eyeglasses, and any metal objects that could obscure the images.
What does the equipment look like?
The equipment used for barium enema examinations at Methodist Diagnostic Center consists of a large, flat table. A moveable apparatus extends over a portion of the table and sends real-time images to a television monitor. Multiple static images are obtained by the radiologist to review later. The table can move and tilt and contains a drawer with a fluorescent plate that captures the image and sends it to a nearby television monitor for viewing.
How does the procedure work?
Very small, controlled amounts of x-ray radiation are passed through the body. Different tissues - such as bone, blood vessels, muscles, and other soft tissues - absorb x-ray radiation at different rates. When a special film plate is exposed to the absorbed x-rays, an image of the inside of the body is captured. The tissues of the lower GI tract are similar in density, so a contrast material is used to help produce clearer images. Barium, a dense metallic chemical, is introduced into the colon through a rectal tube. The barium coats the inside of the rectum, colon, and a part of the lower small intestine, and produces a sharp, well-defined images.
How is the procedure performed?
A lower GI radiological (Barium Enema) examination is usually done on an outpatient basis. The radiologist or technologist will ask a series of questions about potential allergies and prior sensitivity to contrast material. You will be positioned on the table, a preliminary film is obtained to check for adequacy of the bowel preparation. The technologist will then make the contrast injection by inserting a small tube into the rectum. A mixture of barium and water is passed into your colon through the tube. To help the barium thoroughly coat the lining of the colon, air may also be injected through the tube. Then a series of images is captured.
You may be repositioned frequently, to enable the radiologist or technologist to capture views from several angles.
Once the x-ray images are completed, most of the barium is drawn back into a bag, and the patient is directed to the washroom to expel the remaining barium and air. In some cases, the technologist may then take additional images to help the doctor see how well the colon has cleared. The exam is complete and you will be released.
A lower GI study typically takes between 30 and 60 minutes.
What will I experience during the procedure?
As the barium fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure, or even minor cramping. These are common sensations, and most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the technologist know.
During the imaging process, you will be asked to turn from side to side, and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel, the table will be positioned for upright spot films.
Most patients are able to return to a normal diet and activities immediately after the exam. Your stools may appear white for a day or so, as your body clears the metallic liquid from your system. After a barium enema, some people experience constipation. If you do not have a bowel movement for more than two days after your exam, or are unable to pass gas rectally, call your doctor promptly. You may need an enema or laxative to assist in eliminating the barium, and your doctor will prescribe the right solution for you.
Who interprets the results and how do I get them?
Our radiologist will analyze the images and fax a signed report with the interpretation to the your personal physician. The physician's office will inform you on how to obtain your results.
What are the benefits of barium studies?
With the use of the barium contrast material, lower GI imaging provides valuable, detailed information to assist physicians in diagnosing and treating conditions from ulcers to cancer.
- X-ray imaging of the lower GI tract is a minimally invasive procedure with rare complications.
- The imaging process is fast and painless.
- Radiology examination can often provide enough information to avoid more invasive procedures, such as colonoscopy.
In rare cases, the barium suspension could leak through an undetected perforation in the lower GI tract, producing inflammation in surrounding tissues. Even more rarely, the barium can cause an obstruction in the gastro intestinal tract, called barium impaction. The effective radiation dose from this procedure is about 4 mSv, which is about the same as the average person receives from background radiation in 16 months.
Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant.
Radiation risks are further minimized by:
- the use of high-speed x-ray film that does not require much radiation to produce an optimal image.
- technique standards established by national and international guidelines that have been designed and are continually reviewed by national and international radiology protection councils.
- modern, state-of-the-art x-ray systems (including mammography systems, angiographic labs and CT scanners) that have very tightly controlled x-ray beams with significant filtration and x-ray dose control methods. Thus, scatter or stray radiation is minimized and those parts of a patient's body not being imaged receive minimal exposure.
What are the limitations of Lower GI Tract Radiography (Barium Enema)?
A barium enema is usually not indicated for someone who recently experienced a sudden attack of bleeding or abdominal pain. X-ray imaging is not usually indicated for pregnant women.