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Barium enema: What to expect

  • A Barium enema is a diagnostic test using barium to coat the lining of the rectum to see the lower intestine, which includes the colon and rectum. Barium is a milky fluid that absorbs x-rays.

    What to expect

    • Your intestines must be empty before this test. The day before your test, you are asked to take some of the following steps to empty the colon as directed by your physician:
    • Eat a clear liquid diet
    • Take laxatives
    • Take warm water enemas
    • Do not eat or drink anything after midnight

    The day of the exam

    • You can expect to put on a hospital gown and lie on an x-ray table.
    • The room will be darkened during the test.
    • You will hold your breath when x-ray pictures are taken.
    • You will change positions.
    • The x-ray table will be tilted to different positions.
    • here is usually no anesthesia. In some cases, you may be given an injection to relax the rectum.

    Description of the barium enema

    A well-lubricated enema tube is gently inserted into the rectum. Barium is injected through this tube into the colon and rectum. A small balloon at the end of the tube is inflated to keep the barium inside. X-rays are taken. After x-rays are taken, the enema tube is removed and you will be shown to the bathroom to eliminate the barium fluid.

    After expelling the barium, the enema tube is reinserted. A small amount of air will be passed into the colon, and more x-rays are taken. The tube is then removed. You will again go to the bathroom to expel air and any remaining barium.

    After the exam

    • You will be shown to the bathroom to pass the barium, and you may be given a laxative to help.
    • You will likely feel some mild to moderate abdominal cramping that may require you to wait awhile before driving home.

    How long will it take?

    One to two hours

    Will it hurt?

    You may feel some discomfort when the enema tube is inserted. During the test, you may feel some discomfort, including bloating and severe cramping. You may feel as if you need to move your bowels.

    Possible risks

    • Inflammation of the lining of the rectum due to an allergic reaction to latex
    • Perforated rectum or colon (a serious condition, but very rare)
    • Fetal malformation, if done during pregnancy

    Follow-up care

    • You can return to your regular diet immediately following the test.
    • You can return to regular activities immediately following the test (or as soon as you feel able).
    • You should drink lots of fluids because barium can cause dehydration and constipation.
    • You may need to take laxatives to help pass barium.
    • Your stool may appear white or gray for 2-3 days after the test, due to the barium.

    The results of your test

    A radiologist will examine the x-rays. (In rare cases, if the x-rays are blurred, the test may have to be repeated.) Usually within a few days, your doctor will tell you the results. If results are abnormal, your doctor will recommend follow-up testing and treatment options.

    Call your doctor if any of the following occur

    • Severe pain
    • Your doctor does not call with the results within 3-5 days

    (References: National Digestive Disease Information Clearinghouse, U.S. National Library of Medicine, University of Iowa Department of Radiology, The Merck Manual of Medical Information. Merck & Co., Inc., 2000.)

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