A barium enema, or lower gastrointestinal (GI) examination, 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 make 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 inserted into the anus. The barium
blocks X-rays, causing the barium-filled colon to show up clearly on the X-ray
There are two types of barium enemas.
- In a
single-contrast study , the colon is filled with
barium, which outlines the intestine and reveals large
- 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
detailed view of the inner surface of the colon, making it easier to see
narrowed areas (strictures),
diverticula, 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. But if the results are not clear, a double-contrast study may also be
Why It Is Done
A barium enema is done to:
- Identify inflammation of the intestinal wall that occurs in
inflammatory bowel diseases, such as
ulcerative colitis or
Crohn's disease. A barium enema also may be used to
monitor the progress of these diseases.
- Find problems with the
structure of the large intestine, such as narrowed areas (strictures) or
pockets or sacs (diverticula) in the intestinal wall.
- Help correct
a condition called ileocolic
intussusception , in which the end of a child's small
intestine protrudes into the large intestine.
- Evaluate abdominal
symptoms such as pain, blood in stool, or altered bowel habits.
- Evaluate other problems such as anemia or unexplained weight loss.
How To Prepare
Before a barium enema, tell your
doctor if you:
- Are or might be pregnant.
allergic to latex. Latex products are commonly used to administer the contrast
material. If you have a latex allergy, different products will be
- Know that you are allergic to barium.
- Have had an
upper digestive barium test (upper GI or barium swallow) recently.
- Have had a colonoscopy or sigmoidoscopy recently.
The preparation for a barium enema usually involves a very
thorough cleansing of the large intestine, because the colon must be completely
clear of stool and gas. Even a small amount of stool can affect the accuracy of
- For 1 to 3 days before the test, you will
usually be on a
clear liquid diet.
- On the day before the
- You should drink very large amounts of
noncarbonated clear liquids, unless your doctor has advised you not
- You will then take a combination of laxatives to empty your
- You may be asked to take a tap water
enema to clean any remaining stool from your
- On the day of the test, you may need to repeat
the enema until the liquid that passes is free of any stool particles.
rectal suppository or a commercially prepared enema,
such as a Fleet enema, is used instead of a tap water enema.
Talk to your doctor about any concerns you have regarding
the need for this test, its risks, how it will be done, or what the results
will mean. To help you understand the importance of this test, fill out the
medical test information form(What is a PDF document?).