Barium Enema

Overview

What is barium enema?

Barium enema is an X-ray examination of the rectum and colon. It is also called a lower gastrointestinal tract radiography. The study is performed by pouring contrast (liquid containing barium sulfate) through a tube inserted into the anus. This liquid coats the inside of the large intestine and clearly shows its outline on an X-ray image. These pictures help the doctor to detect abnormalities of the colon.

Why is barium enema done?

A barium enema helps a doctor to see the shape, lining and size of the colon and rectum. Your physician may request that you have a barium enema to assess symptoms, such as the following:

The exam may diagnose diseases, including:

Test Details

What should I expect before the barium enema?

If you are pregnant, might be pregnant or breast-feeding, you need to tell your doctor before the barium enema test is done. When scheduling the test, your doctor will ask you what medications you take and about any potential allergies. The doctor will let you know which medications you can take the day before and morning of the test. In addition, you will need to purchase a 10-ounce bottle of magnesium citrate, Dulcolax® tablets and a Dulcolax suppository.

The day before the test you will not be allowed to eat solid foods or drink dairy. You will only be allowed to have the following:

  • Water
  • Clear broth
  • Clear fruit juices without pulp (apple, white grape, lemonade)
  • Clear drinks (clear soda, sports drinks)
  • Coffee or tea (do not use milk, cream, or non-dairy creamer)
  • Plain Jell-O (no added fruit or toppings)
  • Popsicles

The doctor will also give you instructions about how many ounces of water to drink throughout the day. Also, the doctor will tell you when to drink the magnesium citrate and when to take the Dulcolax tablets and suppository.

What should I expect during the barium enema?

  • The barium enema test takes around an hour to complete. You will remove clothing and jewelry and put on a gown prior to the study.
  • You will lie on your side on an X-ray table beneath an X-ray machine. A tube is inserted into your rectum. The barium will slowly flow through the tube into your colon. If your physician has requested a double contrast study, a small amount of air will also be delivered through the tube.
  • X-rays are taken and you may be asked to hold your breath a few times. You may feel abdominal pressure or cramping. You may also feel the need to have a bowel movement. It is important that you resist the urge and you will be given a bed pan or assisted to the bathroom at the appropriate time.
  • You will be asked to turn from side to side and hold different positions as X-rays are taken. Also, the exam table may be raised and tilted to spread the barium through the colon. When the radiologist is sure the necessary images have been obtained, the tube is removed.
  • You will be taken to the bathroom to empty the barium from your colon, and a final X-ray may be taken.

What should I expect after the barium enema?

After the test, drink plenty of fluids and eat high fiber foods such as whole grains, vegetables or fruits to expel the remaining barium in your colon. You may also take a mild laxative as needed. Your stool may be light in color for a couple of days due to the barium. You can return to normal activities after the examination.

Results and Follow-Up

What do the test results from a barium enema mean?

The X-ray images will be examined by a radiologist and a report will be sent to your doctor. The results will be discussed with you at a later appointment. Based on the findings, your doctor may recommend additional testing or treatment.

What are the risks to a barium enema?

This is a minimally invasive test with few complications. Rare complications include the following:

  • Colon perforation
  • Severe constipation (impaction) or obstruction from residual barium that hardens
  • Allergic reaction to barium

When should I call the doctor after the barium enema?

Call your doctor if you experience any of the following:

  • Inability to have a bowel movement or pass gas within two days of the exam
  • Severe belly pain or distention
  • Rectal bleeding
  • Fever

Last reviewed by a Cleveland Clinic medical professional on 09/19/2018.

References

  • HealthReach. Barium Enema. (https://healthreach.nlm.nih.gov/document/520/Barium-Enema) Accessed 10/9/2018.
  • Radiologyinfo.org. X-ray (Radiography) – Lower GI Tract. (https://www.radiologyinfo.org/en/info.cfm?pg=lowergi) Accessed 10/9/2018.
  • Canadian Cancer Society. Barium enema. (http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/tests-and-procedures/barium-enema/?region=on) Accessed 10/9/2018.
  • American Society of Clinical Oncology. Barium Enema. (https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/barium-enema) Accessed 10/9/2018.

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