What is Barium Enema?
A barium enema is a specialized X-ray examination used to assess the large intestine (colon) for abnormalities. Often referred to as a colon X-ray, this diagnostic tool helps visualize the structure and function of the colon through the introduction of a barium solution, which enhances the clarity of images taken during the procedure.
During a barium enema, a liquid containing barium—a metallic compound— is injected into the rectum through a small tube. Barium coats the lining of the colon, which typically yields clearer images compared to standard X-rays that struggle to visualize soft tissues. For improved imaging, air may also be introduced, a technique known as an air-contrast or double-contrast barium enema. This process helps expand the colon, allowing for a more detailed view.
Preparation for the Exam
Proper preparation is crucial for accurate results. Before undergoing a barium enema, patients are instructed to empty their colons completely. This ensures that any residual matter does not obscure the X-ray images. Preparation may involve:
- Dietary Adjustments: Patients may need to follow a clear liquid diet the day before the procedure, consuming only water, clear broth, and certain beverages without dairy.
- Fasting: Typically, patients are asked not to eat or drink anything after midnight before the exam.
- Laxatives or Enemas: The night before the procedure, patients may take a laxative or use an enema kit to further cleanse the colon.
- Medication Review: It’s important to consult a healthcare provider about any regular medications, as some may need to be paused before the exam.
Purpose of the Exam
Historically, barium enemas were frequently employed to investigate abdominal symptoms such as:
- Abdominal pain
- Rectal bleeding
- Changes in bowel habits
- Unexplained weight loss
- Chronic diarrhea
- Persistent constipation
Additionally, this examination may have been used to identify conditions like:
- Abnormal growths, such as polyps, as part of colorectal cancer screening
- Inflammatory bowel disease
While barium enemas have played a significant role in diagnostics, newer imaging technologies, such as CT scans, are often preferred today due to their enhanced accuracy.
Risks and Considerations
While generally safe, a barium enema can pose certain risks, though they are rare. Potential complications include:
- Inflammation in tissues surrounding the colon
- Obstruction in the gastrointestinal tract
- Tear in the colon wall
- Allergic reactions to barium
Due to the exposure to X-rays, barium enemas are usually not performed during pregnancy to avoid risks to the developing fetus.
What to Expect During the Exam
The barium enema procedure usually lasts between 30 to 60 minutes. Here’s what patients can expect:
- Initial Setup: Patients will wear a hospital gown and remove any jewelry or accessories that might interfere with imaging.
- Positioning: The exam begins with the patient lying on their side. An initial X-ray will be taken to confirm that the colon is clean.
- Barium Introduction: A lubricated enema tube is inserted into the rectum, and the barium solution is introduced. If an air-contrast method is used, air will also be introduced at this stage.
- Image Capture: Patients may be asked to change positions on the exam table to ensure comprehensive coverage of the colon. The radiologist might apply pressure to the abdomen to optimize imaging. Multiple X-rays will be taken from various angles.
After the Exam
Once the procedure is completed, the majority of the barium will be removed through the enema tube. Patients can then use the restroom to expel any remaining barium and air. It’s common to experience some abdominal cramping during and shortly after the procedure.
In the days following the exam, patients may notice white stools as the body expels any residual barium. Staying hydrated and consuming a diet rich in fiber can help mitigate constipation, which may occur after the exam.
Interpreting Results
After the examination, the radiologist prepares a report based on the findings and sends it to the patient’s healthcare provider. The results can be categorized as follows:
- Negative Result: Indicates no abnormalities detected in the colon.
- Positive Result: Suggests abnormalities may be present, necessitating further investigation through additional tests, such as a colonoscopy, for more thorough evaluation.
If the quality of the X-ray images is deemed unsatisfactory, repeat examinations or alternative diagnostic methods may be recommended.