Overview of barium enema
A barium enema is a type of X-ray imaging test that allows doctors to examine your lower intestinal tract. It involves delivering a contrast solution that contains the metallic element barium into your rectum while a technician takes X-ray images of the area. The barium solution will be delivered using an enema a process in which your doctor pushes a liquid into your rectum through your anus.
The barium solution helps improve the quality of x-ray images by highlighting certain areas of tissue. The x-ray used in this procedure is called fluoroscopy. Tracking the flow of barium solution through your intestinal tract allows the radiologist to see your internal organs in motion.
The test does not require pain relievers or anaesthetics, but there may be cases that cause short-term discomfort.
Why is a barium enema done?
Your doctor may order a barium enema if he suspects an abnormality in your lower gastrointestinal (GI) tract. Some several conditions and symptoms may cause your doctor to examine your lower GI tract, including:
- Abdominal pain
- Blood in your stool
- A change in your bowel movements
- Crohn’s disease
- Chronic diarrhoea
- Colon cancer
- Irritable bowel syndrome
- Rectal bleeding
- Loop of twisted intestines (volvulus)
- Ulcerative colitis
How to prepare for the barium enema
Your doctor will ask you to clean your intestines the night before the test. This may include the use of laxatives or enemas at home.
You should not eat anything after midnight before the procedure. This is to make sure your colon is clear of stool, which can be seen on x-ray images. Tell your doctor if you have problems with your bowel movements before the test.
How a barium enema is performed
A barium enema typically takes between 30 and 60 minutes and is performed at a hospital or specialized testing facility. You’ll change into a hospital gown and remove any jewellery or other metal from your body. Metal can interfere with the X-ray process.
You’ll be positioned on an exam table. X-rays will be taken to ensure that your bowels are clear. This may also involve a physical rectal exam.
The radiologist will then insert a small tube into your rectum and introduce the barium and water mixture. The radiologist may gently push air into your colon after the barium has been delivered to allow for even more detailed X-ray images. This is called an air-contrast barium enema.
The technician will instruct you to hold still and hold your breath while the X-ray images are taken. You’ll most likely be repositioned several times to take pictures of your colon from different angles. This may cause you some discomfort and cramping, but it’s typically mild.
If you’re having trouble keeping the solution in your colon, alert the technician.
After the procedure, the majority of the barium and water will be removed through the tube. The rest you’ll pass in the bathroom.
Barium enema results
The results are usually classified as negative or positive. A negative result means that no abnormalities were found. A positive result means that abnormalities are found. This usually means that more tests are needed.
Your doctor will discuss your results with you and the next steps.
The risks from a barium enema
There is a risk of cancer, including X-rays, in any radiation-related test. However, the benefit of an accurate diagnosis outweighs the risks of the small amount of radiation you are exposed to during the test. Be aware that many of the things you do regularly, like flying an airplane, will expose you to more radiation than X-rays.
If you are pregnant or think you are pregnant, tell your doctor. X-rays are not recommended for pregnant women because radiation can harm the fetus.
If you have a tear, also known as a perforation in the colon, you can choose the opposite solution with iodine. This solution causes fewer potential problems if it comes out of your colon.
The most common risk factor for a barium enema is an allergic reaction to the barium solution.
Other rare problems with the barium enema include:
- Inflammation of the tissues around your colon.
- Blockage of your gastrointestinal tract.
- Perforated colon
- A tear in the wall of your colon.
Following up after a barium enema
After the test, you will get to know your day as usual. You can resume a normal diet, but you should drink plenty of water and increase your fibre intake. This means how much water you should drink and eat foods like whole-wheat pasta, beans, peas, and raspberries. Sometimes a laxative is needed to remove the barium.
A few days after the procedure, you may notice that your stools are whiter or lighter in colour than usual. It is caused by barium and is considered normal. There may be pain in the rectum and anus.
If you have difficulty with bowel movements, fever, or rectal bleeding, call your doctor. If you have no bowel movements or gas for two days after the test, call your doctor.