Fluoroscopy - Barium Enema (BE)

What is a Barium Enema?

A barium enema is the fluoroscopic evaluation of the large intestine, also known as the colon, after it is filled with a contrast material called barium.

What are some common uses of the procedure?

A barium enema is performed to view the function of the colon and to identify abnormalities such as ulcers, polyps or cancer.  The procedure is often performed for patients suffering from chronic diarrhea, blood in stools, constipation, unexplained weight loss, a change in bowel habits or to detect a source of blood loss.

How should I prepare for the procedure?

Have a light breakfast the morning before your exam.  Have a liquid lunch and begin Golytely at 5, 6 or 7 pm.  Drink for three hours.  When done drinking (at 8, 9 or 10 p.m.), take 4 Dulcolax tablets.  Drink only water and then nothing after midnight.

Before the procedure begins you will be asked to remove all jewelry and to change into a gown, so that no metal items will show up on the images.

Women should always inform their physician or technologist if there is any possibility that they may be pregnant.

What does the equipment look like?

You will be positioned on an exam table.  Above you will be a box-like structure containing the x-ray tube and fluoroscopic equipment that will send the images to a screen in the exam room.  Underneath the table will be a special drawer that holds film in a cassette tray for the development of still images.

How does the procedure work?

The radiologist will monitor the flow of barium into the colon with a fluoroscope, a device that projects radiographic images in real time onto a screen in the exam room.  Still images will then be obtained.

How is the procedure performed?

Barium enemas are usually scheduled in the morning to reduce your time of fasting.

A technologist will position you on the exam table.  An x-ray will be taken to ensure the colon is sufficiently prepped for the exam.  Next an enema tip will be inserted into the rectum, and a balloon will be inflated to prevent the tip from coming out of the rectum.  Barium will flow into the colon until the entire colon is visualized.  Some barium enemas also require the use of air (known as an air contrast or double contrast barium enema).  Still images will then be taken in various positions.  The technologist will check all images to make sure they are acceptable.  Some images may need to be repeated.  After the images have been evaluated for sufficient information, the barium will be drained from the colon, and the enema tip will be removed.  You will be instructed to go to the restroom to try to expel any remaining barium.  When you return from the restroom, one additional image will be taken.

The exam is usually completed within 1 hour.

What will I experience during the procedure?

There is some discomfort associated with the insertion of the enema tip and the inflation of the balloon.  Also, you will experience a sensation similar to bloating and/or cramping during the procedure, as if you need to go to the restroom.  Some patients experience discomfort as a result of lying on the exam table, a hard surface that is typically quite cold.

Who interprets the results and how do I get them?

A radiologist will interpret the images, and a signed report will be sent to your physician who will discuss the results with you.