Barium Enema

A barium enema is a test that is used by medical personnel in determining changes or abnormalities in the large intestine or colon. This procedure is also known as a colon X-ray.

An enema is simply a procedure that involves injecting a liquid into your rectum through a small tube. This liquid usually contains the metal Barium that coats the lining of the colon.

Under normal circumstances, an X-ray produces a poor image of soft tissues, but the barium coating results in a relatively clear silhouette of the colon.

During this examination, air may pump into the colon. The air will expand and this improves the quality of the produced X-ray images. This is known as an air contrast (double contrast) barium enema.

Prior to a barium enema, you will be instructed by your doctor, to completely empty your colon.

There are many reasons to decide to undergo barium enema, including :

• Abdominal pain
• Rectal bleeding
• Unexplained weight loss
• Changes in bowel habits
• Chronic diarrhoea
• Persistent constipation

This test can also help your doctor identify conditions such as Abnormal growths (polyps). Inflammatory bowel disease.

A barium enema only poses a small number of potential risks. The rare complications of a barium enema may include the following:

• Inflammation of the tissues around the colon
• Obstruction in the gastrointestinal tract
• Tear in the colon wall
• Allergic reaction to the metal barium

In general, barium enema exams are not performed during pregnancy because X-rays present a risk to the developing fetus.

To prepare for a barium enema exam, you will receive instructions to clear your colon. A residue in the colon can pose a threat to the production of a clear X-ray image.

To empty your colon, you may be asked to do the following:  

Follow a special diet before the exam. This includes not eating and only drinking clear fluids like water, tea, or coffee without milk or cream, broth, and clear carbonated drinks.

Fast after midnight. In most cases, you will be asked to not to eat or drink anything after midnight before the exam. Take a laxative the night before the exam.

A laxative in pill or liquid form will assist you in the emptying of your colon. Use an enema kit. In some cases, you may need to use  an over-the-counter kit, either the night before the exam or just a few hours before it.

This provides a cleansing solution to remove any residue in your colon. Ask your doctor about your medication.  

It is advised to speak with your doctor at least a week before your exam about the medication you take on a normal basis. He or she may ask you to stop taking them days or hours before the exam.

Here’s what you can expect before, during, and after your barium enema exam:

During your barium enema, you'll wear a gown and be asked to remove eyewear, jewelry or removable dental devices.

The exam will be performed by a radiology technician and a physician who specializes in diagnostic imaging (radiologist). You'll begin the exam lying on your side on a specially designed table.

An X-ray will be taken to make sure your colon is clean. Then a lubricated enema tube will be inserted into your rectum. A barium bag will be connected to the tube to deliver the barium solution into your colon.

If you're having an air-contrast (double-contrast) barium enema, air will flow through the same tube and into your rectum. The tube that's used to deliver the barium has a small balloon near its tip.

When positioned at the entrance of your rectum, the balloon helps keep the barium inside your body. As your colon fills with barium, you may feel the urge to have a bowel movement.

Abdominal cramping may occur. Do your best to hold the enema tube in place. To relax, take long, deep breaths. You may be asked to turn and hold various positions on the exam table.

This helps ensure that your entire colon is coated with barium and enables the radiologist to view the colon from various angles. You also may be asked to hold your breath at times.

The radiologist may press firmly on your abdomen and pelvis, manipulating your colon for better viewing on a monitor attached to the X-ray machine. A number of X-rays will likely be taken of your colon from various angles.

A barium enema exam typically takes about 30 to 60 minutes. After the exam After the exam, most of the barium will be removed from your colon through the enema tube.

When the tube is removed, you'll be able to use the toilet to expel additional barium and air. Any abdominal cramping usually ends quickly, and you should be able to return to your usual diet and activities right away.

You may have white stools for a few days as your body naturally, removes any remaining barium from your colon. Barium may cause constipation, so you may find you can reduce your risk of constipation by drinking extra fluids in the days following your exam.

Your doctor may recommend a laxative if needed. Check with your doctor if you're unable to have a bowel movement or pass gas more than two days after the exam or if your stool doesn't return to its normal color within a few days.

The radiologist prepares a report based on the findings of the barium enema exam and further sends it to your doctor.

Your doctor will then speak to you about your results, as well as subsequent tests or treatments that may be needed: Negative result.

A barium enema exam is considered to be negative if the radiologist detects no abnormalities in the colon. Positive result. A barium enema test is positive if the radiologist detects abnormalities in the colon.

Depending on the discoveries, you may need additional testing, such as a colonoscopy, so that additional abnormalities may be examined more intricately, biopsied or removed.

If your doctor shows concern about the quality of your X-ray images, he or she may recommend a repeat barium enema or a different type of diagnostic examination.