How Common Are Barium Enemas?

  • Medical Author:
    Dennis Lee, MD

    Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Ask the experts

I recently had a colonoscopy and the doctor was not able to complete it because he was not able to get the scope around a bend in my intestines. He is recommending I have a barium enema to complete the exam. How common is this?

Doctor's response

The objective of a colonoscopy is to examine the entire colon (from rectum to cecum. (The cecum is the part of the colon where the small intestine joins the colon. It also is the area of origin of the appendix.) More than 90% of the time, an endoscopist can reach the cecum with a colonoscope safely. The reasons for not being able to reach the cecum with a colonoscope include:

  1. The colon is very long.
  2. The colon is very curvy and redundant.
  3. Pelvic adhesions due to prior surgery or intra-abdominal inflammation (for example, diverticulitis) make the colonoscopy difficult.
  4. There is excessive patient discomfort.
  5. Patients develop abnormal medical conditions (heart rhythm, blood pressure, breathing) that make the endoscopist want to terminate the procedure before reaching the cecum for reasons of patient safety.

If the doctor cannot reach the cecum, he/she may order a barium enema to help visualize the unexamined part of the colon. An alternative to barium enema is computerized tomographic (CT) colonography.

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Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

"Tests for screening for colorectal cancer: Stool tests, radiologic imaging and endoscopy"
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Last Editorial Review: 7/11/2017

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