Barium enema

Definition

Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.

Alternative Names

Lower gastrointestinal series; Lower GI series; Colorectal cancer - lower GI series; Colorectal cancer - barium enema; Crohn disease - lower GI series; Crohn disease - barium enema; Intestinal blockage - lower GI series; Intestinal blockage - barium enema

How the Test is Performed

This test may be done in a health care provider's office or hospital radiology department. It is done after your colon is completely empty and clean. Your provider will give you instructions for cleansing your colon.

During the test:

How to Prepare for the Test

Your bowels need to be completely empty for the exam. If they are not empty, the test may miss a problem in your large intestine.

You will be given instructions for cleansing your bowel using an enema or laxatives. This is also called bowel preparation. Follow the instructions exactly.

For 1 to 3 days before the test, you need to be on a clear liquid diet. Examples of clear liquids are:

How the Test will Feel

When barium enters your colon, you may feel like you need to have a bowel movement. You may also have:

Taking long, deep breaths may help you relax during the procedure.

It is normal for the stools to be white for a few days after this test. Drink extra fluids for 2 to 4 days. Ask your provider about a laxative if you develop hard stools.

Why the Test is Performed

Barium enema is used to:

The barium enema test is used much less often than in the past. Colonoscopy is done more often now. Another alternative, CT colonography, has been used as well.

Normal Results

Barium should fill the colon evenly, showing normal bowel shape and position and no blockages.

What Abnormal Results Mean

Abnormal test results may be a sign of:

Risks

There is low radiation exposure. X-rays are monitored so that the smallest amount of radiation is used. Pregnant women and children are more sensitive to x-ray risks.

References

Boone D, Plumb A, Taylor SA. The large bowel. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 22.

Rubesin SE. Barium studies of the small bowel. In: Gore RM, ed. Textbook of Gastrointestinal Radiology. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed April 12, 2023.


Review Date: 1/7/2023
Reviewed By: Jason Levy, MD, FSIR, Northside Radiology Associates, Atlanta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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