Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.
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
This test may be done in a doctor's office or hospital radiology department. It is done after your colon is completely empty and clean. Your doctor will give you instructions for cleansing your colon.
During 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:
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 doctor about a laxative if you develop hard stools.
Barium enema is used to:
The barium enema test is used much less often than in the past. Colonoscopy is done more often now.
Barium should fill the colon evenly, showing normal bowel shape and position and no blockages.
Abnormal test results may be a sign of:
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.
A rare, but serious, risk is a hole made in the colon (perforated colon) when the enema tube is inserted.
Boland GWL. Colon and appendix. In: Boland GWL, ed. Gastrointestinal Imaging: The Requisites. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 5.
Chernecky CC, Berger BJ. Barium enema. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:183-185.
Taylor S, Plumb A. The large bowel. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 29.
Lin JS, Piper MA, Perdue LA, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;315(23):2576-2594. PMID: 27305422 www.ncbi.nlm.nih.gov/pubmed/27305422.