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Programs & Services
Barium Enema
Also lower gastrointestinal (GI) tract radiography,called a lower GI, a barium enema, is an x-ray examination of the large intestine, also known as the colon. This includes the right or ascending colon, the transverse colon, the left or descending colon, sigmoid colon and the rectum. The appendix and a portion of the distal small intestine may also be included.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.
Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.
Common Uses
A physician may order a lower GI examination to detect:
- benign tumors (such as polyps).
- cancer.
- causes of other intestinal illnesses.
The procedure is frequently performed to help diagnose symptoms such as:
- chronic diarrhea.
- blood in stools.
- constipation.
- irritable bowel syndrome.
- unexplained weight loss.
- a change in bowel habits.
- suspected blood loss.
- abdominal pain.
Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.
Before the Procedure
- Inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials.
- Also inform your doctor about recent illnesses or other medical conditions.
- On the day before the procedure you must not to eat, and to drink only clear liquids like juice, tea, black coffee, cola or broth, and to avoid dairy products.
- After midnight, you should not eat or drink anything.
- You must take a laxative (in either pill or liquid form) and use an over-the-counter enema preparation the night before the exam and possibly a few hours before the procedure. Just follow your doctor's instructions.
- You can take your usual prescribed oral medications with limited amounts of water.
During the Procedure
- You will be asked to remove some or all of your clothes and to wear a gown.
- You will also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
- Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
How is the procedure performed?
The lower GI exam is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiology technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the barium enema.
The patient is positioned on the examination table and the technologist will then insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium and water into the colon. Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon. In some circumstances, the radiologist or referring physician may prefer a water and iodine solution rather than barium. Next, a series of x-ray images is taken.
You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.
The patient may be repositioned frequently on order to image the colon from several angles.
When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
Once the x-ray images are completed, most of the barium will be emptied through the tube. The patient will then expel the remaining barium and air in the restroom. In some cases, the additional x-ray images will be taken.
A barium enema is usually completed within 30 to 60 minutes.
What will I experience during and after the procedure?
As the barium fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure or even minor cramping. Most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the technologist know.
During the imaging process, you will be asked to turn from side to side and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel (air contrast barium enema), the table may be turned into an upright position.
After the examination you can resume a regular diet and take orally administered medications unless told otherwise by your doctor. You will be encouraged to drink additional water for 24 hours after the examination.
Your stools may appear white for a day or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need an enema or laxative to assist in eliminating the barium.
Upper GI Exam
Definition
An upper gastrointestinal tract radiography, also called an upper GI exam, is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that uses a special form of x-ray called fluoroscopy and an orally ingested contrast material called barium.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
Common Uses
An upper GI examination helps evaluate digestive function and to detect:
- ulcers.
- tumors.
- inflammation of the esophagus, stomach and duodenum.
- hiatal hernias.
- scarring.
- blockages.
- abnormalities of the muscular wall of GI tissues.
The procedure is also used to help diagnose symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices)
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
Before Your Procedure
- Inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
- Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.
- To ensure the best possible image quality, your stomach must be empty of food. Therefore, you must not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum and smoking after midnight on the day of the examination.
- You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
How is the procedure performed?
This examination is usually performed on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiological technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the upper GI series.
As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review.
The patient will be asked to hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image.
For a double-contrast upper GI series, the patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken.
When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
This exam is usually completed within 20 minutes.