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Last updated: 11/24/2009
To begin a barium enema, the doctor will have the patient lie with their back down on a tilting radiographic table so that x rays can of the abdomen can be taken. The film is then reviewed by a radiologist, who assesses if the colon has been adequately...
cleansed of stool during the prep process. After being assisted into a different position, a well-lubricated rectal tube is inserted through the anus. This tube allows the physician or the assisting health care provider to slowly administer the barium into the intestine. While this filling process is closely monitored, the patient must keep the anus tightly contracted against the rectal tube so that the position is maintained and the barium is prevented from leaking. This step is emphasized to the patient because inaccuracy may occur if the barium leaks. A rectal balloon may also be inflated to help the patient retain the barium. The table may be tilted or the patient may be moved to different positions to aid in the filling process.
As the barium fills the intestine, x rays of the abdomen are taken to distinguish significant findings. There are many ways to perform a barium enema. One way is that shortly after filling, the rectal tube is removed and the patient expels as much of the barium as possible. Alternatively, the tube will remain in place, and the barium will move through that tube. A thin film of barium remains in the intestine, and air is then slowly injected through the rectum and to expand the bowel lumen. Usually no films will be taken until after the air is injected. Multiple films are generally obtained by a radiologist; then, additional films are made by a technologist.
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A lower gastrointestinal series, also called a barium enema, is a medical procedure used to examine and diagnose problems with the human colon (large intestine). X-ray pictures are taken while barium sulfate fills the colon via the rectum.
This test may be done in a hospital or clinic radiology department. The patient lies on the X-ray table and a preliminary X-ray is taken. The patient is then asked to lie on the side while a well lubricated enema tube is inserted into the rectum. As the enema enters the body, the patient might have the sensation that their stomach is being filled. 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 (often called a "double-contrast" exam). If air is used, the enema tube will be reinserted (if it had been removed; whether it is depends on who does the exam) and a small amount of air will be introduced into the colon, and more X-ray pictures are taken.
The patient is usually asked to move to different positions and the table is slightly tipped to get different views.
If there is a suspected bowel perforation, a water-soluble contrast is used instead of barium. The study is otherwise very similar, although the images are not quite as good. (The concern with existing perforation is that contrast will leak from the bowel to the peritoneal cavity, and water-soluble material, compared to barium is less obscuring at laparotomy.)
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