A barium enema is an x-ray examination of the lower bowel or colon, by a water enema containing barium sulfate. Additionally air will be used. This allows the inside of the colon to be visualized on a fluoroscope and on x-ray films and to detect changes or abnormalities in your colon. A lubricated enema tube will be inserted into the rectum. The tube is connected with a barium bag to deliver liquid barium into your colon. You will be asked to turn and maintain various positions during the exam. This helps to ensure that the entire colon is coated with barium and allows the radiologist to view the colon from various angles. You will be asked to hold your breath at times, while a film is exposed. As your colon fills with barium, you may feel the urge to have a bowel movement. Taking long, deep breaths through your mouth may help to relax. The exam takes 10 to 20 minutes. Cramping usually ends soon after the exam. At the end of the exam you can empty the barium and the air in the toilet.
This test allows the doctor to examine your colon for:
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Ulcers
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Narrowed areas (strictures)
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Growths of the lining (polyps)
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Small pouches in the wall (diverticula)
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Cancer
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Other abnormalities
Your preparation for the examination is exceedingly important. It may well determine whether or not the examination is successful. Follow these directions carefully. Eat nothing else. Necessary medication may be taken with a small amount of water. If the colon is not completely empty of stool before the exam, parts of the colon may not be well visualized on the X-ray. In this case, there may be abnormalities that can not be detected such as small polyps.
1. Diet , starting two days before exam, allowed are:
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plain water, tea and coffee without milk or cream, carbonated beverages
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any juice without pulp (no orange juice or tomato juice)
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broth, spaghetti, rice, cooked noodles with butter, eggs in any form, steamed fish
Not allowed are meals which produce indigestible residuals, such as meat, vegetables, fruits and nuts. Milk and milk products such as cheese etc., bread and cookies should be avoided. On the day of the exam drink only.
2. Drinking fluid:
In addition to diet, the bowels must be thoroughly cleaned and therefore you must drink 3-4 liters of the liquids suggested above per day, starting two days before exam. If you are being treated for a renal failure or other diseases with restricted fluid intake, consult your referring physician for special preparation.
3. Laxative:
Drink the X-Prep® at about 4 pm on the day before exam. Afterwards drink at least 1 litre of the recommended fluid. This will probably cause considerable diarrhoea and may cause some discomfort, usually in the late evening or early in the morning. The possibility of such an occurrence should be considered in scheduling important business or social events in the evening before the examination. After having taken the X-Prep, eat a light liquid meal (e.g. bouillon, fruit juice, and plain gelatin. No solid foods. No dairy products, such as milk, cream, or cheese. If you have severe kidney disease, cramping abdominal pain, major diarrhoea, intestinal bleeding, or inflammatory bowel disease, check with your primary doctor before using X-PREP®
4. Morning of the exam:
Patients are asked to give themselves a cleansing enema (Clysmol®) at least 1 hour before leaving for your exam. Shake bottle well. Remove protective shield from rectal tip: Hold bottle upright, grasping grooved bottle cap with fingers. Grasp protective shield with other hand. Pull gently to remove. With steady pressure, gently insert enema tip in rectum, with tip pointing toward your navel. Squeeze bottle until nearly all liquid is expelled. Remove tip from rectum. A small amount of liquid will remain in bottle after squeezing. Maintain position for 5 to 10 minutes, if possible, before emptying the colon.
On the day of your exam: Drink at least one cup of coffee, tea or strained fruit juices, but have no other breakfast.
The test results are available shortly after the examination.
Factors that may affect test results
After the examination, it is important to drink as much liquid as is comfortable, to replace the fluid you have lost. Usually you should not have any trouble getting rid of the barium If you are troubled by constipation, a mild laxative of your choice may be advisable. Your stool may be light colored for 24 - 72 hours after the exam, as the remaining barium is expelled from your colon. If no further X-rays are ordered, resume normal diet.
