Barium enema

A series of X-rays of the lower intestine.

Barium Enema

Barium enema, often referred to as a "lower GI (gastrointestinal) series," is a radiographic examination of the large intestine (colon) using a contrast medium called barium sulfate. This diagnostic procedure is primarily used to visualize and assess the health and structure of the colon and rectum, allowing for the detection of abnormalities like polyps, tumors, or inflammatory conditions.

Overview

The barium enema is a valuable tool in the armamentarium of a radiologist. It employs barium, a metallic compound, to coat the lining of the colon, making the area more visible on X-ray films. The procedure provides detailed images which can be crucial in diagnosing various intestinal pathologies.

Procedure

A typical barium enema procedure involves the following steps:

1. Preparation: The patient usually undergoes a bowel cleansing regimen one or two days prior. This may involve a restricted diet, intake of laxatives, and enemas to clear out fecal material.
2. Administration: The patient lies on an X-ray table, and a lubricated tube is gently inserted into the rectum. The barium sulfate solution is then introduced into the colon.
3. Imaging: As the barium fills the colon, multiple X-ray images are taken. The patient may be repositioned several times to obtain various views.
4. Completion: Once imaging is finished, the barium solution is drained out as much as possible, and the patient can use the restroom to expel any remaining solution.

Indications

Barium enemas are indicated for various diagnostic purposes, including but not limited to:

• Detection of tumors or polyps
• Diagnosis of inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis
• Evaluating unexplained blood in stools or chronic diarrhea
• Monitoring progress post-surgical procedures on the colon

Risks and Side Effects

As with any medical procedure, barium enemas carry potential risks:

• Allergic reactions: Some patients might have an allergic reaction to the barium or other substances used during the test.
• Bowel perforation: Rarely, the procedure might cause a tear in the lining of the colon.
• Constipation: Residual barium can harden in the colon leading to constipation, which may require laxatives or enemas for relief.
• Radiation exposure: As with any X-ray examination, there's a slight risk due to radiation exposure.

Alternatives

While barium enemas have been a traditional choice for visualizing the colon, newer methods like colonoscopy and CT colonography are often preferred due to their higher precision and ability to both diagnose and treat abnormalities in a single session.

FAQS

How is it done?

The x-rays are taken after the patient is given an enema with a white, chalky solution that contains barium.

Purpose

The barium outlines the intestines on the x-rays.

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  Barium Contrast Enema (commons images)

See Also

• Gastrointestinal tract
• Radiography
• Colonoscopy
• Medical imaging

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