- Barium Enema Center
- Take the Pancreatitis Quiz
- Boost Digestive Health
- Digestive Distress Slideshow: Problem Foods to Avoid
- Patient Comments: Barium Enema - Indications
Barium enema series facts
- A barium enema (lower GI series) is an X-ray procedure used to define the anatomy of the large intestine (colon) and the rectum.
- A barium enema involves filling the colon and rectum with a white liquid material (barium) often followed by air (double-contrast barium enema).
- The risks of barium enema includes discomfort, radiation exposure, and perforation of the colon.
- Women who are or may be pregnant should notify the doctor requesting the procedure and the radiology staff because of the risk of radiation exposure to the fetus.
What is a barium enema series?
A lower GI series, also known as a barium enema, barium enema procedure, barium enema X-ray or double-contrast barium enema, is an X-ray test in which a white liquid, called barium, is infused through a catheter (tube) inserted through the anus and into the rectum until it fills the large bowel (colon). X-ray films of the colon then are taken so that the outline of the colon can be seen. The barium enema and double contrast barium enema are used to define normal and abnormal anatomy of the colon and rectum. Colon and rectal abnormalities that can be detected include diverticulosis, polyps, dilation of the colon, Hirschsprung disease in infants, and colon cancers.
What are the risks of a lower barium enema?
Distention of the colon is uncomfortable, but only a few patients find it very painful. Any X-ray test procedure involves some risk of radiation exposure. The radiation exposure is minimized by standard techniques which have been developed and approved by national and international radiology committees and councils. All radiology technologists are certified by national certifying boards.
Women who are or may be pregnant should notify the doctor requesting the procedure and the radiology staff, as there is a potential risk of harm to the fetus with any radiation exposure. Complications of barium enema examination are rare. The tip of the enema catheter or distention of the colon can penetrate the wall of the colon and give rise to a localized infection (abscess) or peritonitis (generalized infection of the abdominal cavity). This usually occurs only when excessive pressure is used to infuse the barium or there is already a diseased colon that is weakened.
Quick GuideDigestive Disorders: Common Misconceptions
How does the patient prepare for a lower barium enema, and how is it performed?
Any internal or external materials that make an X-ray image less clear can interfere with the accuracy of a barium enema. Therefore, before undergoing a barium enema (lower GI), it is important to eliminate as much fecal material from the colon and rectum as is possible. Prior to the examination, a clear liquid diet and cleansing enemas often are used to empty the colon. Further medications that help evacuate the bowel are usually used. This is called a bowel prep. External materials such as extra clothing, metallic devices, or jewelry are removed prior to the test. A radiologist (a doctor specializing in the use and interpretation of X-rays) and a radiology technologist work perform the procedure on the patient.
- A barium enema involves filling the colon and rectum with a white liquid material (barium) through a catheter (tube) inserted into the rectum through the anus. It is normal during the procedure to feel some fullness or mild discomfort in the abdomen.
- Subsequently, an X-ray machine is placed in front of the patient with X-ray film behind.
- Images of the colon then are obtained by exposing the abdomen to the radiation. The contrast in density between the barium-filled colon and other structures of the abdomen are apparent on the X-ray film and give an excellent outline of the colon.
- The radiologist also will use a fluoroscope, an X-ray device on which the barium can be seen in motion flowing into the colon.
- Further static images of the colon then are obtained on plain X-ray film or digital computerized image.
- The barium then may be drained so that only a small amount of barium remains sticking to the lining of the colon, and air is infused into the colon to distend it.
- Further X-rays then are taken which give more detail of colon's lining than the X-rays of the barium-filled colon. This latter procedure is called a double contrast barium enema since both air and barium are used to provide the images. Polyps and small cancers are more readily found using this technique (called an air contrast barium enema).
- A barium enema can take anywhere from fifteen minutes to an hour depending on the problem being studied and the particular anatomy of the patient's colon.
How does the patient obtain the results of a lower barium enema series?
After the X-ray films are developed by the radiology technologist, they are transmitted to the radiologist, who interprets the body structures visualized on the X-ray film. An interpretation and report of the barium enema is forwarded to the doctor who requested the test usually within one to two days. The doctor then can review the results of the report with the patient. The actual films of the examination also can be sent to the health care practitioner if necessary.
Digestive Disorders Resources
Doubeni, Chyke, MD, FRCS, MPH. "Tests for screening for colorectal cancer: Stool tests, radiologic imaging and endoscopy." UptoDate. Updated Aug 23, 2016.
Top Barium Enema Related Articles
Abdominal Pain (Causes, Remedies, Treatment)
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers.
Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination.
Treatment for abdominal pain depends upon the cause.
Appendicitis is an inflammation of the appendix. Appendicitis often causes sings and symptoms such as abdominal pain in the lower right quadrant, nausea, vomiting, abdominal tenderness, fever, and loss of appetite.
Delay in surgery can result in appendix rupture with potentially serious complications.
Blood in the Stool (Rectal Bleeding)
Blood in the stool or rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Common causes include
- anal fissures,
- Crohn's disease,
- colon and rectum polyps, and
The color of the blood in the stool may provide information about the origin of the bleeding. The color of stool with blood in it may range from black, red, maroon, green yellow, gray, or white, and may be tarry, or sticky. Treatment of blood in the stool depends on the cause.
Cancer DetectionCancer detection are methods used to find cancer in persons who may or may not have symptoms. Symptoms of cancer are abnormal sensations or conditions that persons can notice that are a result of the cancer. It is important to your doctor for regular checkups and not wait for problems to occur.
ColitisColitis refers to inflammation of the inner lining of the colon. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis, including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, ulcerative colitis, infectious colitis like C. difficile, or microscopic colitis). Treatment depends on the cause of the colitis.
Colon Cancer ScreeningColon cancer is preventable by removing precancerous colon polyps, and it is curable if early cancer is surgically removed before cancer spreads to other parts of the body. Therefore, if screening and surveillance programs were practiced universally, there would be a major reduction in the incidence and mortality of colorectal cancer.
ColonoscopyA colonoscopy is a procedure whereby a docotor inserts a viewing tube (colonoscope) into the rectum for the purpose of inspecting the colon. Colonoscopy is the best method currently available to diagnose, detect, and treat abnormalities within the colon.
Colon Cancer SlideshowColorectal cancer (colon cancer) is the cause of many cancer deaths. Learn about the warning signs, symptoms, screening process, stages, and treatment related to colorectal cancer.
DiarrheaDiarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
Diverticulitis SlideshowDiverticulitis (diverticulosis) is a condition in which the diverticulum or diverticula rupture in the colon causing infection. Change in diet and medical treatments such as antibiotics and surgery can ease the symptoms of diverticulitis (diverticulosis).
Fecal Occult Blood TestsA fecal occult blood test (FOBT) is performed on samples of stool in order to detect occult blood in otherwise normal–colored stool. There are two types of fecal occult blood tests: chemical and immunologic. FOBT is primarily used to detect colon cancer. The test can also help discover colon polyps, some of which are a precursor of colon cancer.
Intestinal Gas (Belching, Bloating, Flatulence)
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air.
Causes of bloating or distension include tumors, ascites, fluid within the gastrointestinal (GI) tract, and obesity.
Causes of gas or flatulence are diseases such as sugary foods and drinks, fruits and vegetables, starches (wheat, oats, corn, and potatoes), lactose intolerance, untreated celiac disease, and SIBO.
Treatment for excessive intestinal gas depends on the cause. If anal itching persists, a doctor examination may be needed to identify an underlying cause.
Intestines PictureThe intestines are a long, continuous tube running from the stomach to the anus. See a picture of the Intestines and learn more about the health topic.