Barium Enema

What is a barium enema?

A barium enema is an X-ray procedure that allows your doctor to examine your colon. A barium enema involves putting barium inside the colon through a tube inserted into the rectum. Barium is a chalky metallic contrast material that helps illuminate the colon so that the X-ray images show as much detail of the colon as possible. A barium enema produces still pictures as well as moving images of the colon in action using a special type of X-ray called fluoroscopy. A barium enema is also known as a lower GI (gastrointestinal tract) series or lower GI tract radiography.

The colon, also called the large intestine or large bowel, is a long, hollow organ in your abdomen that plays an important role in digestion by removing water from digested material and forming feces. A barium enema can help your doctor find the reason for unexplained intestinal symptoms you may be having, such as changes in your bowel movements, abdominal pain, or rectal bleeding.

A barium enema is only one method used to diagnose a variety of conditions. You should discuss all your diagnostic options with your doctor or healthcare provider to best understand which option is right for you.

Why is a barium enema performed?

Your doctor may recommend a barium enema to diagnose a variety of diseases and conditions that affect the colon and rectum including:

• Abdominal pain if the underlying cause has not been found through other, less invasive tests. Abdominal pain can be caused by an array of conditions from inflammatory bowel disease to intestinal ulcer.
• Abnormal changes in your bowel movements, such as chronic constipation or diarrhea
• Anemia (low red blood cell count) if the underlying cause has not been found through less invasive testing. A barium enema may be able to identify potential bleeding sites.
• Bleeding symptoms, such as rectal bleeding, bloody stool, or black, tarry feces. Potential causes of such bleeding include colon cancer and intestinal inflammation or damage.
• Colon cancer. A barium enema can identify abnormal growths, polyps, and masses in the intestines.
• Colon polyps, abnormal growths in the large intestine that can become cancerous
• Diverticulosis and diverticulitis, intestinal pockets that can develop over time and become infected
• Inflammatory bowel disease, which includes ulcerative colitis and Crohn's disease
• Irritable bowel syndrome (IBS). A barium enema may be used to rule out other causes of IBS symptoms, such as a blockage in your intestines.
• Unexplained weight loss if the underlying cause has not been found through less invasive testing

How is a barium enema performed?          

Your barium enema will be performed in a hospital radiology department, outpatient setting, or doctor’s office. The procedure will be completed by a radiologist, a physician specialized in radiology, and a radiologic technologist, a medical professional specialized in radiology and the care of patients during radiology procedures. Your barium enema will take about an hour or less and generally includes these steps:

1. You will dress in a patient gown and lie on an examination table.
2. The radiologic technologist will position you on the table and take a preliminary X-ray to make sure the colon is cleaned out well enough to take good pictures.
3. The radiologic technologist will instill the barium mixture slowly into the colon through a small, lubricated enema tube that is inserted into the rectum. A small amount of air may also be injected to help the barium spread more evenly in the colon and obtain the best images.
4. The radiologic technologist will take a series of painless X-ray pictures. You will be repositioned as needed to get pictures of different areas of the colon.
5. After all the X-rays have been taken, you will wait briefly while the pictures are checked for quality, then most of the barium will flow out of the colon through the enema tube, and the tube will be gently removed. The radiologic technologist may take more pictures before removing the tube.