Barium Enema

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BARIUM ENEMA (BE): Patient preparation:

In order to perform an optimal barium enema (BE) examination, the colon must be clean. The patient takes a strong laxative the night before the barium enema test and cleansing enemas in the morning. If there is any residual stool present in the colon at the time of the barium enema test, the small bits of stool may be mistaken for colon polyps and the BE test may need to be repeated. Drugs: 1 mg IV glucagon may be given to the patient just prior to the introduction of the barium into the rectum to relax the colon and reduce abdominal cramping.

Procedure:

The BE test can be uncomfortable because an enema tube with a retention balloon is inserted into the rectum and liquid barium is allowed to flow from an enema bag into the colon. If the procedure is very uncomfortable, inform the radiologist. He may be able to give you glocagon to relief some of the cramping. There is a single contrast or full column technique, and an air-contrast technique. The single contrast is faster and easier to tolerate but the double contrast examination is slightly more accurate for polyp detection.

The radiologist is in attendance during the test, observing the flouroscopic image while the barium column fills the colon. Spot X-ray films are taken by the radiologist. The radiologist then leaves the examining room and larger overhead X-rays of the abdomen are taken by the technologist. The enema tube is then removed. The patient is instructed to evacuate the colon in the toilet, and a post-evacuation X-ray film of the abdomen is taken. The films are checked with the radiologist and if no further X-rays are needed, the study is ended and the patient is returned to home.

Findings typically seen on Barium Enema:

The BE examination is used to detect such diseases as diverticuli, diverticulitis, polyps, masses, obstruction, ulceration, cancer, and infection.

Possible Risks and Complications:

A rare complication is perforation of the colon and leakage of barium into the peritoneal cavity. If this possibility is a consideration, then a water-soluble form of material called Gastrograffin is used instead of barium.

Next test after a BE:

A colonoscopy, performed by a gasteroenterologist is often done to confirm abnormal findings on the BE and to biopsy of any polyps or masses found in the colon.