There are two different types of barium enemas.
- Single-contrast barium enema: In this study, the colon is filled with barium, which has the potential to identify abnormalities in the large intestine.
- Double-contrast or air-contrast barium enema: This study starts similarly to the single-contrast study. However, after the colon is filled with barium it is drained out. This technique leaves a thin layer of barium on the wall of the colon. The colon is then filled with air which allows a better view of the inner surface of the colon.
Your physician may order a barium enema to detect or diagnose benign tumors, inflammatory bowel diseases (such as ulcerative colitis) or cancer. A barium enema is used to diagnose common gastrointestinal symptoms such as diarrhea, blood in the stool, constipation and abdominal pain.
What to Expect: During the Procedure
A single-contrast barium study usually takes 30 to 45 minutes, while a double- or air-contrast study may take up to an hour.
You will lie on the X-ray table while a preliminary X-ray film is taken. You will be instructed to lie on your side. A lubricated tube is inserted into the rectum and the barium is slowly injected. The contrast material blocks X-rays so that the colon can be seen clearly.
Your doctor will observe the flow of the barium through your colon on an X-ray monitor.
The doctor will ask you to turn to different positions, and the X-ray table may be tilted slightly to help the barium flow through your colon. This is done in order take X-rays from different angles and directions.
If a double-contrast study is being done, the barium will be drained out and your colon will be filled with air.
What can be found?
According to the National Institutes of Health, in a normal study, the barium will fill the colon evenly. The bowel shape will appear normal with no blockages.
In an abnormal test, the colon may show abnormalities that may be indicative of:
- Blockage of the large intestine
- Colitis due to Crohn’s disease
- Cancer in the colon or rectum
- Sliding of one part of the intestine into another
- Small growths that stick out of the lining of the colon, called polyps
- Small, bulging sacs or pouches of the inner lining of the intestine, called diverticulosis
- Twisted loop of the bowel
What happens afterwards?
In most cases, you will be instructed to return to your regular diet. You are instructed to drink plenty of liquid to replace fluids and flush out any remaining barium in your system.
It is typical for bowel movements to appear look white or pinkish for 1 to 2 days after the study. It is common for your doctor to recommend a laxative to help you pass the rest of the barium.
How to Prepare
Prior to having a barium enema you must tell your doctor if you are or might be pregnant. It is also important to disclose if you are allergic to latex or barium and if you have recently undergone other gastrointestinal tests (colonoscopy, sigmoidoscopy, etc.).
To prepare for a barium enema, you need to thoroughly cleanse your large intestine much like a colonoscopy. For 1 to 3 days prior to a barium enema, you will need to be on a clear liquid diet.
You may be asked to take a tap water enema to clean any remaining stool from your colon.