Rectal cancer, X-ray
Rectal cancer, X-ray
Sigmoid colon cancer, X-ray
Sigmoid colon cancer, X-ray
Barium enema
Barium enema

Barium enema

Definition:
An X-ray examination of the large intestines, pictures are taken after rectal instillation of barium sulfate (a radiopaque - contrast medium).

Alternative Names:
Lower gastrointestinal series

How the test is performed:
This test may be done in an office or a hospital radiology department. You lie on the X-ray table and a preliminary X-ray is taken. You are asked to lie on the side while a well lubricated enema tube is inserted gently into your rectum. The barium, a radiopaque (shows up on X-ray) contrast medium, is then allowed to flow into the colon. A small balloon at the tip of the enema tube may be inflated to help keep the barium inside. The flow of the barium is monitored by the health care provider on an X-ray fluoroscope screen (like a TV monitor). Air may be puffed into the colon to distend it and provide better images.

You are asked to move to different positions and the table is slightly tipped to get different views. At certain times when the X-ray pictures are taken, you hold your breath and be still for a few seconds.

The enema tube is removed after the pictures are taken and you are given a bedpan or helped to the toilet. You then expel as much of the barium as possible. One or two X-rays may be taken after the barium is expelled.

If a double or air - contrast examination is being done, the enema tube will be reinserted gently and a small amount of air will be gently introduced into the colon, and more X-ray pictures are taken. This gives a more detailed picture. The enema tube is then removed, and you again empty the colon.
How to prepare for the test:
Thorough cleaning of the large intestine is necessary for accurate pictures. Test preparations include a clear liquid diet, drinking a bottle of magnesium citrate (a laxative), and warm water enemas to clear out any stool particles.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
There is a feeling of fullness during the procedure, moderate to severe cramping, the urge to defecate, and a general discomfort. The X-rays themselves are painless.
Why the test is performed:
The test is used to detect colon cancer. The barium enema may also be used to diagnose and evaluate the extent of inflammatory bowel diseases.
Normal Values:
Barium should fill the colon uniformly and show normal bowel contour, patency (should be freely open), and position.
What abnormal results mean:
Abnormal findings may include cancer, diverticulitis (small pouches formed on the colon wall that can become inflamed), polyps (a tumor, usually noncancerous, that grows on the mucous membrane), inflammation of the inner lining of the intestine (ulcerative colitis), and irritable colon. An acute appendicitis or twisted loop of the bowel may also be seen.

Additional conditions under which the test may be performed:
What the risks are:
There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits. Pregnant women and children are more sensitive to the risks of the X-ray.

A more serious risk is a perforated colon, which is very rare.
Special considerations:
CT scans and ultrasounds are now the tests of choice for the initial evaluation of abdominal masses.

Review Date: 12/2/2001
Reviewed By: Evan Mair, M.D., Department of Radiology, Boston Medical Center Boston, MA. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.