A barium enema is an X-ray exam used to help diagnose certain problems in the lower bowel.
A healthcare provider may recommend a barium enema in the following cases: if a person has blood in the stool or notices blood on toilet paperif a person has a change in bowel habitsto evaluate the part of the colon not seen on sigmoidoscopyif a person has a family history of colorectal polyps or colorectal cancerto check the colon after surgeryto help fix a twisted bowelto evaluate fever or lower abdominal pain
A barium enema can cause moderate discomfort. During this test, a person lies on the X-ray table. The person is usually asked to roll onto his or her left side. The technologist or radiologist will insert a lubricated enema tip into the rectum. The tip has a balloon that can be inflated just enough to keep liquid from leaking out.
A bag hanging on a pole holds the barium solution. This liquid is slowly passed through the bowels while X-rays are taken. The X-ray pictures are projected on a monitor. The person having the test will be asked to roll from side to side. The table may be tilted up or down, to get the best pictures. As each X-ray is taken, the person must hold his or her breath briefly.
Once the whole bowel is filled with the solution, the technologist will take more pictures with an overhead X-ray tube. Then the balloon is deflated and the enema tip is removed. The person goes to the bathroom to expel as much as possible of the barium solution. After that, he or she returns to the table so the emptied bowel can be X-rayed.
Sometimes, an air-contrast study is done, which is similar to a regular barium enema. In a one-stage air-contrast exam, the air and barium are put into the bowel together. In a two-stage exam, the barium is instilled first. The bowel is emptied and then air is pumped into it.
After the X-rays are done, the person will be asked to wait until the technologist or radiologist is sure no more X-rays are needed.
Before the day of the test, a person will be asked to clean out the lower bowel with an oral laxative and an enema or suppository. Because every exam center has specific instructions for this, it is best to get details from the center before the exam.
Before the test starts, the person will undress completely and put on a hospital gown. All jewelry, including pierced body jewelry, must be removed. The person will be asked if he or she has any metal inside the body or if he or she has had a barium exam in the past 3 to 4 days. A woman will also be asked if she is pregnant.
This kind of X-ray exam can detect the following: an abscess, or pocket of pusabnormal narrowing or enlargement of the bowelcolorectal polypsdiverticulitisdiverticulosispossible bleeding sitesleakage from the bowel into the abdomentumors or abnormal growths in the intestinesa twisted bowelinflammatory bowel diseaseulcersintussusception (the bowel telescopes into itself)foreign bodies in the rectum or colon