Double-contrast barium enema

Human intestinal tract, as imaged via double-contrast barium enema

Double-contrast barium enema

A double-contrast barium enema (DCBE) is a specialized radiographic technique used to visualize the colon and rectum. This diagnostic procedure is employed to detect abnormalities such as polyps, tumors, diverticula, and inflammatory bowel disease.

Procedure

The double-contrast barium enema involves the introduction of a barium sulfate suspension into the colon via the rectum. Barium sulfate is a radiopaque contrast medium that coats the lining of the colon, allowing for clear visualization on X-ray images. After the barium is introduced, the colon is inflated with air to provide a double-contrast effect, enhancing the visibility of the mucosal surface.

Preparation

Prior to the procedure, patients are typically required to follow a special diet and take laxatives to ensure the colon is empty. This preparation is crucial for obtaining clear and accurate images.

Execution

1. The patient lies on an X-ray table, and a lubricated enema tube is gently inserted into the rectum. 2. Barium sulfate is introduced into the colon through the enema tube. 3. The patient may be asked to change positions to ensure even coating of the barium. 4. Air is then introduced to expand the colon, providing a double-contrast effect. 5. Multiple X-ray images are taken from different angles to capture detailed views of the colon.

Indications

A double-contrast barium enema is indicated for:

• Detection of colorectal cancer
• Evaluation of chronic diarrhea
• Investigation of rectal bleeding
• Assessment of abdominal pain
• Screening for polyps and diverticulosis

Advantages

• Provides detailed images of the colon and rectum
• Non-invasive compared to colonoscopy
• Can detect small lesions and mucosal abnormalities

Limitations

• Requires thorough bowel preparation
• May be uncomfortable for some patients
• Less sensitive than colonoscopy for detecting small polyps

Risks

While generally safe, the procedure carries some risks, including:

• Perforation of the colon
• Allergic reaction to barium sulfate
• Discomfort or cramping

Alternatives

Other diagnostic procedures for evaluating the colon include:

• Colonoscopy
• CT colonography
• Sigmoidoscopy

See also

• Barium enema
• Colonoscopy
• Radiology
• Gastroenterology