Do you sometimes have stomach upset, a change in bowel habits, or blood in your stool? At times like these, your doctor may order a special test to see what's going on inside your large intestine. One such test is called a barium enema. The name may sound a little strange, but it's really nothing to be afraid of. Let's take a look at what it is, how it's done, and everything you need to know.
What is a Barium Enema?
Simply put, this is a test that takes X-ray pictures of the inside of your large intestine (colon). But it's not like a regular X-ray. Before the X-ray is taken, a doctor or technician will put a special liquid into your rectum. This is what we call an 'enema' or 'stool'.
The liquid that is injected is called barium. It is a white liquid that looks like chalk powder. When this liquid is well coated on the inner walls of the intestine, the shape of the intestine, small lumps inside, and wounds can be seen very clearly when the X-ray is taken. We call such liquids `(contrast fluid)`.
This test is done in two main ways:
- Single-contrast enema: In this, only the barium liquid is injected.
- Double-contrast enema: In this, a small amount of air is also injected into the colon along with the barium liquid. This causes the colon to swell slightly, allowing even the smallest details on the walls to be seen more clearly.
Why are you being asked to take this test?
Your doctor may recommend this test if you have unexplained symptoms related to your colon. Think about things like this.
| Symptom | Simply put... |
|---|---|
| Rectal bleeding | If you have blood when you defecate or if there is blood in the stool. |
| Change in bowel habits | If there is a sudden change in the frequency, timing, or nature of your bowel movements. |
| Prolonged diarrhea | If you continue to have stomach pain without finding a reason. |
| Unexplained stomach ache | A persistent pain in the lower abdomen. |
| Weight loss for no reason | If you suddenly lose weight without dieting or exercising. |
This test can identify conditions that may be causing your symptoms, such as:
- Anal fistula
- Bowel obstruction
- Colon polyps are small growths that form inside the colon.
- Small pouches that grow out of the walls of the intestine (Diverticulosis)
- Ulcerative colitis
In fact, barium enemas have become less common these days due to tests like colonoscopy. However, in some cases, it has special advantages over other tests.
For example:
- In some areas, this test is easier to perform than a colonoscopy.
- It doesn't involve a major intervention into the body like a colonoscopy, and it doesn't cause loss of consciousness .
- Some people may be allergic to the contrast dye used for a colonography test, but very few people are allergic to barium.
How to prepare for the test?
This is the most important thing. For this test to be successful, your intestines must be completely clean. That means there can't be even a trace of feces inside.
Your doctor will give you a bowel prep kit to help you cleanse your bowels. It will come with a leaflet with clear instructions on how and when to take it. It is very important to follow those instructions exactly.
You will probably have to:
- Eat only a clear liquid diet such as soup water, orange juice, and water for a few days before the test.
- Take the laxative medicine prescribed by the doctor at the prescribed time.
Most importantly: You should definitely tell your doctor in advance about any other medications you are taking (e.g. for diabetes, blood pressure), vitamins, and other medical conditions you have, especially if you are pregnant .
What happens during the test?
This test is usually performed in a hospital's X-ray department (radiology center). The entire procedure takes about 30 to 60 minutes.
1. First, you will be given a hospital gown to wear.
2. You will then be turned on your side on the examination table and made to lie down. You will not lose consciousness, so you will be able to feel everything and even speak.
3. Then a radiology technician will carefully insert a small, lubricated tube into your anus.
4. It is through this tube that the barium liquid is slowly passed into the intestine.
5. While the barium is in the stomach, you will be turned in different positions (right, left, up) to take X-ray pictures. Sometimes you will be asked to hold your breath for a while. This is done so that the barium liquid spreads throughout the intestines.
6. Once the images are taken, the tube will be removed and the barium will be flushed out. You will be given the opportunity to go to the bathroom to flush out the rest.
As the fluid fills your stomach, you may feel like you're full and need to defecate. This is normal. But don't worry, there's a small balloon at the end of the tube so nothing comes out.
Are there any side effects or risks?
This is a very safe test, but there are a few things.
- Constipation: This is the most common side effect. The barium may cause your stool to be a little dry. This can be largely prevented by drinking plenty of fluids for two to three days after the test.
- Rare risks: Allergy to barium, leakage of barium through a hole in the intestine, etc. are possible. However, these are very, very rare.
What happens after the test and when should I talk to the doctor ?
Once the test is over, you can go home, eat, drink, and work as normal.
- Stomach discomfort: You may experience a slight discomfort in your stomach, a feeling of fullness, for an hour or two. This will gradually go away.
- White stool: Your stool may become white for a few days. That's because of the barium. That's normal, don't worry.
However, if you experience any of the symptoms below, you should contact your doctor immediately .
| When to seek immediate medical advice | |
|---|---|
| Symptom | Description |
| Severe stomach pain or bloating | If you have unbearable stomach pain or your stomach is bloated like a stone. |
| Fever | If your body is hot and you have a fever. |
| Blood in the stool | If there is blood in the stool. |
| Dizziness or weakness | If you feel so weak that you can't stand. |
| Incontinence | If you are unable to defecate or pass gas two days after the test. |
It may take a few days to receive the test report. Once the report is received, the doctor will call you to explain the results and what to do next.
Take-Home Message
- A barium enema is a generally safe X-ray test used to diagnose diseases of the colon.
- To achieve good results, it is essential to cleanse the intestines thoroughly according to the doctor's instructions.
- Inform your doctor in advance about any other medications you are taking and any other medical conditions you have.
- Drink plenty of water after the test to avoid constipation. It is normal to have white stools for a few days.
- If you experience any unusual symptoms such as severe stomach pain, fever, or bleeding, notify your doctor immediately.
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