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Barium enemaPublished by Bupa's health information team, healthinfo@bupa.com, June 2007. This factsheet is for people who are considering having a barium enema. Your care may differ from what is described here because it is adapted to meet your individual needs.
About barium enemaA 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:
What are the alternatives to barium enema?Alternative imaging procedures include ultrasound, magnetic resonance imaging (MRI) and computerised tomography (CT). Your doctor will discuss which procedure is most suitable for you. Preparing for your barium enemaIf you normally take medication (eg tablets for blood pressure), continue to take this as usual, unless your doctor specifically tells you not to. If you are unsure about taking your medication, please contact your doctor. 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. The hospital will give you detailed advice beforehand. You will usually be allowed to drink clear fluids until immediately before the test. You will be given a laxative, which will come with detailed instructions on how and when to take it. Depending on the type of laxative you are given, the effect can be quite powerful and you may need to stay close to a toilet. Please follow the bowel preparation instructions carefully. If your bowel isn't completely empty, it may not be possible to get the required information from your test. If you have diabetesFollow your doctor's advice and make sure you have enough to eat on the day before your appointment to prevent low blood sugar levels. What to expect at the hospitalYou must tell your radiographer about any medicines you are taking and if you have any allergies, glaucoma or heart disease. If you are a woman of childbearing age, you will be asked if you are pregnant. This test is not recommended for pregnant women, unless there is an urgent medical reason. Please tell your radiographer if you could be pregnant. Your radiographer will explain the procedure and ensure that you are happy to proceed with the test. About the procedureThe barium enema test usually takes 15 to 20 minutes. In a private cubicle, you will be asked to remove your clothing and put on a hospital gown. You will be taken to the X-ray room and asked to lie down on the X-ray table on your side. You may be given an injection of a muscle relaxant to help relax the muscles of your bowel wall, and make the barium enema 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 enough 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 you some discomfort. You may feel cramp-like pains for a short while. What to expect afterwardsWhen you feel ready, you will be able to go home. If you have muscle relaxants you should wait an hour before driving. It is best to arrange for someone to drive you home. Try to take it easy at home and stay within reach of a toilet for the first few hours. You should drink clear fluids regularly and try to eat vegetables, fruit, and high fibre foods. This helps to maintain regular bowel movement and prevent constipation. ResultsA report will be sent to the doctor who requested your test. The report can take several days to reach your doctor. Before you go home, you should ask your radiographer when you can expect to get your results. What are the risks?Barium enemas are commonly performed and generally safe. In order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications for this procedure. 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. If you are pregnantPregnant women are advised not to have X-ray tests as there is a risk the radiation may cause some damage to the unborn child. If you could be pregnant, please tell your doctor or radiographer. Side-effects of barium enemaThese are the unwanted but mostly temporary effects of a successful test. 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. Muscle relaxants can temporarily blur your eyesight. Vision should improve after 30 minutes. Complications of barium enemaComplications are when problems occur during or after the procedure. 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. Ask your doctor to explain how these risks apply to you. The exact risks will differ for every person. This is one of the reasons why we have not included statistics here. Further information
Sources
Related topicsThis information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2007. Expected review date: June 2009.
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