Barium Enema

What Is It?

A barium enema is a procedure used to examine the lining of the colon and rectum. The procedure is also called a lower gastrointestinal series.

"Barium" refers to barium sulfate, a chalky chemical that appears white on X-ray film. "Enema" refers to any fluid pumped into the rectum through the anus. After the barium sulfate liquid makes its way to your intestines, a series of X-ray pictures are taken. In these X-rays, the white barium fluid allows some abnormalities in the intestines to appear dark. Air may be pumped into the intestine during this procedure to help sharpen the outline of the intestinal wall.

This test takes about 45 minutes. It can be performed as an outpatient procedure, meaning you don't have to stay overnight in a hospital. Although the X-rays themselves are painless, the enema may cause some slight discomfort. You may feel full or gassy.

What It's Used For

Barium enema is used to check for tumors of the colon and rectum. polyps (abnormal growths attached to the intestinal lining by a stalk), diverticulosis or other abnormalities.

As a screening test for colorectal cancer, a barium enema is recommended in some cases instead of colonoscopy. It is performed once every five to 10 years, beginning at age 50. Testing should begin earlier in anyone with a higher risk of colorectal cancer. This includes people who have had colorectal cancer before, and people with ulcerative colitis, a personal or family history of certain types of intestinal polyps or a family history of colorectal cancer.

Because several tests look for colorectal cancer (including digital rectal exam, sigmoidoscopy and fecal occult blood test), your doctor will determine which tests are best for you.

Preparation

To produce good X-ray pictures, your colon and rectum need to be empty. Your doctor will give you instructions about using laxatives and/or enemas before the procedure. Your doctor will also tell you how to modify your diet (when to stop eating and what you can drink).

How It's Done

You will remove your clothing and put on a hospital gown. You will lie on your side on an X-ray table. A tube will be inserted into your rectum and you will be given an enema of barium fluid. As the fluid flows into your intestines, you may feel a little discomfort, pressure or the urge to move your bowels. While you hold the fluid inside your bowels, the X-ray technician will take a series of pictures. To allow the barium fluid to flow into different parts of your bowels, you will change position on the table, and the table itself may be rotated.

Once the X-rays are complete, you will go to a nearby bathroom (or be given a bedpan) to pass the barium fluid from your bowels. You will then have a second series of X-rays. This time, air is gently pumped into your rectum. This air, together with the thin film of barium fluid still in your intestines, will help to enhance the images of your intestinal lining.