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Fluoroscopy - Small Bowel Series (SBFT)

What is a Small Bowel Series?

A small bowel series, also called a small bowel follow through, is the fluoroscopic evaluation of the small intestine after it has been filled with a contrast called barium.

What are some common uses of the procedure?

A small bowel series is performed to view the function of the small intestine and to identify abnormalities such as inflammation, obstructions or dilation of bowel loops.  Patients who undergo this procedure usually complain of abdominal pain, a change in bowel habits including chronic diarrhea or constipation, unexplained weight loss or blood in the stool.  This exam is also useful in diagnosing inflammatory bowel disease such as Crohn's disease.

How should I prepare for the procedure?

Take nothing by mouth 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 that contains the x-ray tube and fluoroscopic equipment that will send the images to a screen in the exam room.  Underneath the table is a special drawer that holds film in a cassette tray for development of still images.

How does the procedure work?

The passage of barium is followed through the small intestine with a series of x-rays.  When the barium reaches the colon, the radiologist will evaluate the last portion of the small intestine, known as the terminal ileum, with a fluoroscope, a device that projects radiographic images in real time onto a screen in the exam room.

How is the procedure performed?

Small bowel imaging is usually scheduled in the morning to reduce your time of fasting.

A technologist will position you on an exam table.  An x-ray will be taken prior to drinking the barium.  You will be instructed to drink a sufficient amount of barium to fill the small intestine.  An x-ray will be taken immediately after you have finished drinking, and again every 20 minutes until the barium reaches the colon.  Transit time will vary for each patient.  After the barium has reached the colon, the radiologist will use the fluoroscopic to evaluate the last portion of the small intestine, or the terminal ileum.  Still images of this area will then be taken.

The examination time will vary for each patient.  It could take from 30 minutes up to 4-6 hours or more.

What will I experience during the procedure?

The liquid barium has a chalky taste.  Some discomfort may be experienced as a result of lying on the exam table, a hard surface that is typically quite cold.

After the procedure, you may resume a regular diet.  The barium may color stools gray or white for 48-72 hours.  Sometimes the barium may cause constipation, which is usually taken care of by an over-the-counter laxative.  You should increase your intake of water to help flush the barium from your gastrointestinal tract.

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.