Barium Enema (barium X-ray; lower GI series)

A barium enema is a rectal infusion of barium given to coat the lining of the colon and rectum. It is done before X-rays are taken to create better X-ray images of the lower intestine. Barium is a milky fluid that absorbs X-rays.

Parts of the body involved:

Colon and rectum.

Reasons for the procedure:

A barium enema is done to enhance X-ray images. X-rays are taken of the colon and/or rectum to look for:

• Abnormal growths, such as polyps or cancers
• Ulcers
• Diverticula (small pouches protruding through the wall of the colon)
• Thickening of the lining of the colon or rectum

For pediatric patients, an unprepped barium enema can be done to screen for Hirschsprung's disease.

Risk factors that may lead to complications:

• Allergy to the latex balloon on the tip of the enema tube (rare)
• Severe rectal inflammation (patients with active colitis should not have a barium enema)
• Pregnancy (X-rays of the abdomen and pelvis should usually not be done during pregnancy)

What to expect prior to the procedure:

Your intestines must be empty before this test. Therefore, the day before your test, do the following:

• Eat a clear liquid diet
• Take laxatives
• Take warm water enemas
• Do not eat or drink anything after midnight

For pediatric patients, your doctor may order an unprepped barium enema. This means your intestines do not need to be empty, and laxatives are unnecessary.

During the procedure:

• You can expect to put on a hospital gown and lie on an X-ray table
• The room will be darkened during the test
• You will hold your breath when X-ray pictures are taken
• You will change positions
• The X-ray table will be tilted to different positions

Anesthesia:

Usually none. In some cases, you may be given an injection to relax the rectum.

Description of the procedure:

A well-lubricated enema tube is gently inserted into the rectum. Barium is injected through the tube into the colon and rectum. A small balloon at the end of the tube is inflated to keep the barium inside. X-rays are taken. After X-rays are taken, the enema tube is removed, and you are shown to the bathroom to expel the barium.

For a double air contrast examination:

After expelling the barium, the enema tube is reinserted. A small amount of air is injected into the colon, and more X-rays are taken. The tube is removed. You are again shown to the bathroom to expel air and any remaining barium.

After the procedure:

You will be shown to the bathroom to pass the barium, and you may be given a laxative to help. You will likely feel mild to moderate abdominal cramping, which may require you to wait a while before going home.

How long will it take?

The procedure will take one to two hours.

Will it hurt?

You may feel some discomfort when the enema tube is inserted. You may feel discomfort during the test, including bloating and severe cramping. You may also feel as if you need to move your bowels.

Possible complications:

• Inflammation of the rectum lining due to an allergic reaction to a latex balloon
• Perforated rectum or colon (serious, but rare)
• Fetal malformation, if done during pregnancy

Average hospital stay:

None.

Postoperative care:

• You can return to your regular diet immediately following the test.
• You can return to regular activities immediately following the test (or as soon as you feel able).
• You should drink lots of fluids because barium can cause dehydration.
• You may be given laxatives to help pass barium, which can cause constipation.
• Due to the barium, your stool may appear white or gray for two to three days after the test.

Outcome:

A radiologist will examine the X-rays. In rare cases, if the X-rays are blurred, the test may have to be repeated. Within a few days, your doctor will tell you the results. If results are abnormal, your doctor will recommend follow-up testing and treatment options.

Call your doctor if any of the following occurs:

• Severe pain
• Your doctor does not call with the results within three to five days.