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A barium enema, or lower gastrointestinal
(GI) exam, is an X-ray examination of the
large intestine (colon and rectum). The test is used to help diagnose
diseases and other problems that affect the large intestine. To have the intestine
visible on an X-ray picture, the colon is filled with a contrast
material containing barium. This is done by pouring the contrast
material through a tube introduced into the anus (hence the name barium enema).
The barium blocks X-rays, causing the barium-filled colon to show up clearly
on the X-ray picture.
There are two types of barium enema.
In a single-contrast study,
the colon is filled with barium,
which outlines the intestine and shows up large abnormalities.
In a double-contrast or
"air-contrast"
study, the colon is first filled with barium and then the barium is drained
out, leaving only a thin layer of barium on the wall of the colon. The colon
is then filled with air. This provides a much more detailed view of the inner
surface of the colon, making it easier to see
small polyps, tumors, or inflammation.
In some cases, the single-contrast
study may be preferred for specific medical reasons or for older people who
may not be able to tolerate the time-consuming and somewhat more uncomfortable
double-contrast study. However, if the results are not clear or if there is
a strong suspicion of colon cancer, a double-contrast study may also be done.
Barium Enema Results
During the test, the fluoroscopic monitor provides the
radiologist with some results, which are recorded on X-ray films. The radiologist
then examines all the X-ray films and interprets the results. Final results
may be available immediately after the exam or the following day.
Normal:
The colon appears normal. A normal-appearing appendix excludes
a diagnosis of appendicitis.
Abnormal:
One or more problems in the colon are detected.
Failure of a section of colon to fill with barium (filling
defects) may be caused by spasms in the colon wall, polyps, cancer, or retained
stool.
If any polyps or growths on the
inner wall of the colon are found, they may need to be evaluated using colonoscopy,
and a biopsy may be done to determine if they are cancerous.
Sacs
in the colon wall diverticulosis may be detected. These can
sometimes
become inflamed or infected diverticulitis.
Other structural defects and inflammation (colitis) of the lining
of the colon may indicate the presence of inflammatory bowel disease
ulcerative colitis or Crohn's disease.
A narrowed segment or a twisted loop of bowel (causing an obstruction)
may also be seen on this test.
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