A barium enema is a special X-ray test used to examine the large bowel (colon and rectum). The bowel does not show up well on plain X-rays. However, if the bowel wall is coated with barium, a white liquid which shows up on X-rays, it makes it possible to examine the bowel.
The examination is routinely done as an out-patient procedure in the imaging or radiology department. A barium enema can help look for signs of inflammation, disease or cancer. The procedure may be used to investigate symptoms such as:
- changes in bowel habits
- blood in stools
- abdominal pain
- unexplained weight loss
About the procedure
It is essential for the bowel to be completely empty in order to get the best information from the examination. To achieve this, you will need to follow a special diet for a day or two and you will be asked not to eat any solids for 24 hours before your test. You will also be given a laxative, which will come with detailed instructions on how and when to take it.
The test itself usually takes 15 to 20 minutes.
You may be given an injection of a muscle relaxant to help relax the muscles of the bowel wall, and make the examination easier to tolerate. The muscle relaxant may be given routinely at the start of the procedure, or only if bowel spasm is seen during the examination.
A soft plastic tube is gently passed into your rectum. During the examination, liquid barium will flow through the tube to coat the bowel wall. Air may be passed through the tube to expand the bowel and make the bowel wall easier to see. You may feel as if you want to go to the toilet. It’s important to try and hold the barium fluid and air in by keeping the muscles of your bottom very tight.
Images of your bowel will be displayed on a TV screen and you may be moved into different positions, both to help the barium flow and to see as much of the bowel as possible. The X-ray table will slowly tilt to get you into position.
Several X-ray images will be taken with you in different positions, some with you lying on your side and some with you upright. When sufficient X-rays have been taken, the tube will be removed. You will be allowed to leave the X-ray room and go to the toilet.
This examination may cause some discomfort. Some patients may feel cramp-like pains for a short while afterwards and muscle relaxants can temporarily blur your eyesight – your vision should improve after 30 minutes.
After having a barium enema you may feel bloated for a short while. You may also feel constipated for a few days and may need to take mild laxatives.
Barium enemas are commonly performed and generally safe. However all medical procedures carry risks as well as benefits.
You will be exposed to some X-ray radiation. Level of exposure is about the same as you would receive naturally from the environment over three years. Pregnant women are advised not to have X-ray tests as there’s a risk the radiation may cause some damage to the unborn child.
There is a small chance the colon may be damaged or perforated during the procedure. This can lead to bleeding and infection, which may require treatment with medicines or surgery.
Your doctor will explain the benefits and risks of having a barium enema and discuss alternatives to the procedure. Depending on your symptoms, alternatives may include:
- virtual colonoscopy
Please see the relevant Spire Healthcare treatment summary sheets for more information.