Barium enema

This procedure is also known as a lower gastrointestinal series. It involves introducing a white metallic compound known as barium sulfate; this liquid can make images visible in X-ray of the rectum, colon and anus.

The Role of Barium Sulfate in Medical Imaging

Barium sulfate is used for medical imaging because it is a dense substance that absorbs x-rays well because of its high atomic number and energy-specific properties. When swallowed or introduced into body cavities, it lines the gastrointestinal tract thereby making its structures visible in x-rays.

It aids in the examination of the shape, movements and condition of the GI tract which helps diagnose conditions such as tumors, ulcers, inflammation among others. In computed tomography (CT) scans, barium sulfate enhances the visibility of the GI tract against surrounding organs, especially when combined with gas and osmotically active agents.

Symptoms

The healthcare provider may recommend a Barium sulfate procedure for the following symptoms.

Chronic diarrhea
Constant constipation
Abdominal pain
Variations in bowel habits
Rectal bleeding
Unexplained weight loss
Anemia

Conditions requiring the procedure:

Inflammatory bowel disease
Colon Cancer Screening
Crohn's disease
Ulcerative colitis
Diverticulosis (Development of small, bulging pouches in the digestive tract)

Contraindications

Healthcare providers must consider contraindications for barium enema before deciding whether to perform it on any patient. Here is a detailed explanation.

A patient should not have barium enema if she/he has previously experienced an allergic or hypersensitivity response towards barium. On occasion, people may exhibit severe hypersensitivity reactions, prompting anaphylaxis emergency treatment by healthcare professionals including difficulty in breathing, throat, or facial swelling.

Barium enema is contraindicated in patients who have had recent examinations of the upper digestive tract involving the use of barium contrast agents like barium swallow or upper GI series. This is because some unabsorbed barium may remain in the body and interfere with correct interpretation of results or lead to false findings during barium enema.

Barium enema shall not be used during pregnancy because it may expose the fetus to radiation.

For example, some devices used in the procedure such as catheters and enema tips may have traces of latex in them. If you are aware that you have a latex allergy, please inform those who will carry out the procedure so that they can use those tools that lack latex to avoid any reactions.

Having Barium enemas should be avoided in patients with a high risk for or already having bowel perforations. Bowel perforation is a rare but very serious complication that occurs especially in patients suffering from various gastrointestinal conditions while undergoing barium enemas.

The reason patients with severe constipation or fecal impact may be poor candidates for barium enema is because it may worsen their conditions. This can lead to further blockage of feces or aggravation of impacts within the colon by introducing additional materials, which could result in pain, complications or prevent full visual inspection of the colon during the process.

Patients with unstable health conditions, such as uncontrolled hypertension severe, cardiovascular disease, or recent myocardial infarction (heart attack), may be at increased risk of complications during a barium enema procedure.

Barium enema needs patient cooperation and the ability to follow instructions. Those unable due to cognitive issues may need alternative methods for safe examination.

Types of Barium Enemas:

Single-Contrast Barium Enema: In this type, only barium sulfate is used as the contrast agent. It helps to outline the inner lining of the colon and provides information about its shape, position, and size.

Double-Contrast Barium Enema (Air-Contrast Barium Enema): This technique involves the introduction of both barium sulfate and air into the colon. The air helps to distend the colon, allowing for better visualization of the colon's inner surface. This technique is beneficial for detecting small polyps and lesions.

Preparing for a Barium Enema

Inform the Doctor about the medical history. The healthcare provider may recommend specific dietary restrictions and bowel preparation instructions for a barium enema, which may vary depending on the preferences and the facility where the procedure is performed. It is essential to abide by the instructions provided by the healthcare team. After confirming procedure planning, the Doctor may advise on the following measures.

For 1 to 3 days before procedure, consume clear fluids like water, fruit juices, plain coffee or tea, and broth. Avoid consuming solid foods, dairy products, and beverages with colored dyes.

It is important to avoid high in fiber foods such as whole grains, nuts, seeds, raw fruits, and vegetables, as well as any foods with skins or peels as these foods can leave residue in the colon, which may interfere with the imaging quality.

On the day prior to the test, drink plenty of fluids unless restricted due to kidney, heart, or liver issues.

A suitable laxative may be provided to clear intestines.

Individuals might be asked to perform a water enema to cleanse the colon.

During the Test:

The patient is subjected to lay down on an X-ray table while a contrast material containing barium is introduced into the colon through a tube inserted into the anus.

The barium highlights the colon on X-ray images.

The patient may be given medicine to ease cramping.

The procedure may take 30 to 45 minutes for a single-contrast study and up to an hour for a double-contrast study.

After the Test:

The tube is removed from the anus and the patient will be given a bedpan or taken to the toilet to expel the barium.

Additional X-rays may be taken post-evacuation.

One can resume a regular diet and increase fluid intake to flush the remaining barium.

Managing Discomfort and Preparation Tips

The preparation and bowel cleaning can be uncomfortable and tiring.

One may experience soreness, cramping, and a strong urge to have a bowel movement during the procedure.

The test may take a while, so consider bringing something to occupy yourself.

Arrange for transportation home, as the test can be exhausting.

Risks:

Complications are rare but may include severe constipation, barium granulomas, or bowel perforation, especially in individuals with existing intestinal issues.

During the procedure the risk of stomach discomfort such as cramping, bloating, or a feeling of fullness may be observed.

In a few cases, a slight risk of perforation or injury to the colon during tube insertion may be observed. However, the healthcare professionals take precautions to minimize this risk.

Conclusion:

Barium enema is an effective diagnostic tool for detecting bowel abnormalities. Despite potential discomfort and risks, careful preparation and adherence to medical guidance can help ensure a successful procedure. Understanding contraindications and managing expectations can contribute to a safer and more effective experience for patients undergoing this examination.

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