Barium Enema

Barium enema is a medical procedure used to identify a problem within the large intestine. It is basically a lower gastrointestinal series, where the human colon is x-rayed as the special enema fills the colon.

Barium enema involves the use of barium sulfate to fill the colon via the rectum, for an effective x-ray of the large intestine. This medical procedure may be applied either at a hospital or in a clinic of any Department of Radiology. The procedure is carried out after a preliminary x-ray is taken. Then, a lubricated enema tube is inserted into the patient’s rectum, to fill the organ. The barium content is viewed on the x-ray as the contrast medium and is allowed into the colon. Sometimes, a small balloon is inflated at the tip of the tube to help keep maintain the barium within.

The doctor then monitors the flow of the barium on a fluoroscope screen, which is pretty much like a regular TV monitor. Many a times, air is puffed into the colon to provide better images. This procedure is also refered to as the double-contrast colon examination. The patient is asked to lie in different positions for different views and sometimes the table is designed to tip at different angles for the desired examination. In the case the doctor or health care provider suspects a bowel perforation, then instead of barium, a water soluble contrast medium is used.

The procedure invloved in barium enema requires a complete cleaning of the large intestine for accurate pictures, prior to the application. The patient is advised to maintain a clear liquid diet prior to the application and take a laxative. The doctor may even advise warm water enemas prior to the barium sulfate application. Barium enemas are usually used to check, identify and diagnose inflammatory bowel diseases like Crohn’s disease, ulcerative colitis, polyps and IBS or irritable bowel syndrome. However, in the removal of polyps, since there is a chance of them being cancerous, colonoscopy is used.

Barium enemas are also used to diagnose diverticulosis or the formation of small, inflamed pouches on the colon wall and many a times, treat and cure intussusception. The procedure can also help to detect an inflamed appendix, which shows up as a twisted loop. The medical procedure may also be performed to identify intestinal obstruction, annular pancreas, CMV gastroenteritis and even Hirschsprung disease. It is important to know that there is a low exposure to radiation via this diagnosis, but the X-rays are monitored and regulated.

The aim of the exposure is simply to produce an image that helps diagnosis. Today, ultra sound examinations and CT scans are conducted for the initial evaluation. Colonoscopies for effective and routine colon screening, especially in the case of senior citzens and patients with a history of colon cancer. Nevertheless, barium enema is advised after a colonoscopy for a second, detailed evaluation. This diagnostic test enables the doctor to see the contour of the colon’s lining and detect any out-pockets, ulcers, fistula or other inflammatory changes. Primarily, barium enema is used to evaluate a wide range of large intestine health conditions.

Although the barium enema is actually a way of diagnosing intestinal disease, now doctors are using the test and evaluation as a screening tool in the case of people who are possible victims of colorectal cancer. Barium enema is also used treat an intestinal condition via the intussusception resolving pressure effect when barium is put into the colon. The telescoping effect causes the colon to fold in on itself and is usually observed in infants. A modified barium enema test is also conducted, called the ‘double-contrast barium enema’, to view the mucous membrane in the colon better.

The fluoroscope plays a major role in such minute viewing of the internal structure. The whole procedure manipulates the position of the person and the amount of barium and air, separately or in combination, that is introduced for proper diagnosis. Barium enema is a preliminary and routine diagnostic tool. This medical procedure is also the most effective in identifying and eliminating or establishing the presence of any large intestinal disease.

By Gaynor Borade
Published: 2/27/2008