Barium Enema
The principle behind the barium enema is quite simple. Barium, a contrasting agent is introduced into the rectum, filling the large intestine. Once the barium has reached its destination, X-rays of the colon are taken.
What is the purpose of this test?
The barium enema allows to see the inside of the large intestine (colon) on an X-ray and may be required for various reasons:
- Diagnosis and follow-up of inflammatory bowel diseases (e.g., Crohn's disease and ulcerative colitis).
- Identifying the cause of:
- a persistent intestinal bleeding
- anemia
- a change in stool
- an abdominal pain
- a sudden, spontaneous weight loss
- Follow-up of abnormal results from other tests, such as a fecal occult blood test.
- Detection of narrowed areas, ulcers and polyps (small masses that have developed in the intestine).
- Detection of suspicious growths or colorectal cancer.
Preparation
The colon generally holds feces. To get a clear view of the colon, it is crucial that it be emptied and cleansed. Each healthcare facility has its own protocol. Before going for a barium enema, make sure that you have read all the instructions that were given to you on how to prepare and make sure that you have all the medication needed to prepare for the procedure.
The protocol usually includes:
- A special diet in the days before the exam.
- One or more laxatives to be taken the day before and the day of the exam.
- Certain medications to be suspended in the days preceding the exam.
The following table contains a list of products that may be included in your barium enema preparation.
| Medication | Commercial names | Description | Dosage examples |
|---|---|---|---|
| Bisacodyl | Dulcolax | Tablet and/or suppository | Take 2 to 4 tablets the day before the procedure. The insertion of 1 suppository into the rectum might be necessary on the morning of the procedure. |
| Polyethylene glycol with electrolytes | Bi-Peglyte, Colyte, Golytely, Moviprep, Peglyte | Powder for oral solution | Dilute with water, then drink 250 mL every 10 minutes to a maximum of 2 to 4 litres or until clear fluid is evacuated from the rectum.Can be taken in 1 dose or 2 separate doses. |
| Sodium picosulfate, magnesium oxide and citric acid | Pico-Salax, Purg-Odan | Powder for oral solution | Dilute each packet in 150 mL of clear liquid, then drink one dose twice according to the instructions you have received. |
| Magnesium citrate | Citrodan, Citro-Mag | Oral liquid | Drink 1 bottle (300 mL) the day before the exam, then 1 bottle (300 mL) the day of the exam. |
Many patients have difficulty tolerating certain formulas. This can lead to inadequate preparation and a postponement of the exam. However, certain measures can improve tolerability:
- Chilling the solution.
- Using a straw to drink the solution.
- Using low-volume formulas.
- Using split-dose preparation (e.g., taking one dose the day before and one dose the day of the procedure).
Nausea, vomiting, and abdominal pain may occur. If these symptoms persist or worsen, the procedure should be discontinued. The same applies if there is any sign of dehydration (e.g., thirst, dizziness, decreased urination) or the onset of a fever.
Procedure
On the day of the appointment, a barium solution will be administered through a tube inserted into the rectum. Once the barium reaches the intestine, it must remain there while the X-rays are taken. The patient will be required to turn several times, as images of all sides of the colon must be taken. Air may also be injected into the intestine for a complementary set of X-rays tests.
Once the barium solution has been administered, it is normal to feel as though you need to defecate. It is also common to experience a feeling of pressure on the abdomen or mild cramps. These symptoms are usually short-lived.
It generally takes 20 to 30 minutes to complete.
After the procedure
The patient is required to drink large quantities of fluids to flush the barium from the system. It is normal for patients to see barium in their stool for a few days after the procedure.
Patients can resume their regular activities and diet after the procedure. Some people may experience constipation after a barium enema. Although this effect is temporary, speak to your healthcare professional if it persists for a few days.
What you should know before going for this test
When you go in for a blood test or any other medical exam, it's always a good idea to bring a complete list of any prescriptions, over-the-counter medications, or natural health products you're taking. Unless otherwise advised, it's best to take your medications as usual on blood test days. If in doubt, don't hesitate to talk to your healthcare professional.
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.