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About Barium EnemasDigestive System

A barium enema, or lower gastrointestinal (GI) series, uses x-rays to diagnose problems in the large intestine, which includes the colon and rectum. The lower GI series may show problems like abnormal growths, ulcers, polyps, and diverticuli.

Before taking x-rays of your colon and rectum, the radiologist will put a thick liquid called barium into your colon. This is why a lower GI series is sometimes called a barium enema. The barium coats the lining of the colon and rectum and makes these organs, and any signs of disease in them, show up more clearly on x-rays. It also helps the radiologist see the size and shape of the colon and rectum.

You may be uncomfortable during the lower GI series. The barium will cause fullness and pressure in your abdomen and will make you feel the urge to have a bowel movement. However, that rarely happens because the tube the physician uses to inject the barium has a balloon on the end of it that prevents the liquid from coming back out.

You may be asked to change positions while x-rays are taken. Different positions give different views of the intestines. After the radiologist is finished taking x-rays, you will be able to go to the bathroom. The radiologist may also take an x-ray of the empty colon afterwards.

A lower GI series takes about 1 to 2 hours. The barium may cause constipation and make your stool turn gray or white for a few days after the procedure. It is usually recommended to drink large quantities of water or clear liquids after the test to help flush the barium out.  Follow the advice of your physician or health care professional in this regard.

Sometimes a barium enema is used along with a flexible sigmoidoscopy in place of a total colonoscopy to evaluate patients for such issues as changes in bowel habits or blood in the stool, either obvious or hidden (occult). This approach has some distinct advantages or disadvantages.  For instance, neither the barium enema nor the sigmoidoscopy is usually performed with sedation.  While some find this uncomfortable, avoiding sedation does help eliminate a bit of risk from the testing process.  One of the main disadvantages is that if an abnormality is found on either the sigmoidoscopy or the barium enema, a total colonoscopy is usually necessary to define the problem further.  If a polyp is found on sigmoidoscopy or barium enema, then a colonoscopy will usually be required to remove it.  This subjects people to multiple procedures and bowel preparations, an approach some find suboptimal.

In preparation for a barium enema, your colon must be empty for the procedure to be accurate. To prepare for the procedure you will have to restrict your diet for some time beforehand. To make sure your colon is empty, you might be given a laxative or an enema before the procedure. Your physician may give you other special instructions.