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barium enema

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Site of barium enema

Barium enema X-rays

Alternative Names
lower GI X-ray, air-contrast barium enema

A barium enema is an X-ray examination used to help diagnose certain problems in the lower bowel.

Who is a candidate for the test?
A doctor may recommend this test:
  • if a person has blood in the stool or notices blood on toilet paper
  • if a person has a change in bowel habits
  • to evaluate the part of the bowel not seen on sigmoidoscopy. Sigmoidoscopy is test that uses a thin, lighted telescope to look inside the lower bowel.
  • if a person has a family history of colorectal polyps or bowel cancer
  • to check the bowel after surgery
  • to help fix a twisted bowel
  • to evaluate fever or lower abdominal distress
How is the test performed?
A barium enema feels moderately uncomfortable. During this test, a person lies on the X-ray table. He or she is usually asked to roll onto their 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 run 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 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 examination, the air and barium are put into the bowel together. In a two-stage examination, 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 are sure they have all the X-rays they need.

What is involved in preparation for the test?
Before the day of the test, a person will be asked to clean out their lower bowel with a laxative and an enema or suppository. Because every examination centre has specific instructions for this, it is best to get details from the centre or doctor before the examination. Before the test starts, the person will undress completely and put on a hospital gown. All jewellery-including pierced body jewellery-must be removed. The person will be asked:
  • if he or she has any metal inside the body
  • if he or she has had a barium examination in the past 3 to 4 days
A woman will also be asked if she is pregnant.

What do the test results mean?
This kind of X-ray examination can detect:
  • colorectal polyps, which are small nodules or growths that occur in the inner lining of the large intestine. These usually grow from the surface of the intestinal lining and grow towards the centre of the intestine.
  • tumours, or abnormal growths that occupy space in the intestines. Tumours can either be benign or represent cancer. Only after a piece of the tumour is taken out and looked at with a microscope can the doctor tell if cancer is present.
  • blood vessel abnormalities
  • possible bleeding sites
  • abnormal narrowing or enlargement of the bowel
  • diverticulitis, or inflammation of a diverticulum. A diverticulum is an abnormal sac that bulges through the intestinal wall.
  • diverticulosis, a condition in which the large intestine is full of multiple diverticulum sacs.
  • an abscess, which is a pocket of pus, or other bowel infection
  • a twisted bowel
  • ulcers
  • leakage from the bowel into the abdomen
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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