How is a barium enema done?

How is a barium enema done?

Humans are born with many systems in the body. Cells and organs work in a mannerly form to become a system. Multiple systems in the body work simultaneously to enable humans to live and survive. Humans are able to adapt with many environments or surrounding thorough changes in the body. However, at times, these changes may actually make humans fall into diseases. Thus, health screening helps to identify health problems early on and help patients to get better treatment. In this article, we will be learning about one of the procedures that may be rare to be heard in health screening but plays a role in identifying disease, known as barium enema.

Barium enema is an examination to see the lower gastrointestinal (GI) tract by using x-ray. Barium enema gives rough pictures of the large intestine which includes colon, rectum and anus. This helps healthcare professionals to see changes or problems affecting those structures. Barium enema is also known as colon x-ray, lower GI x-ray or lower GI radiography.

There are many reasons a person may be asked by a healthcare provider to undergo barium enema procedure. This includes patients that experienced abdominal pain, changes in bowel habits, constipation, diarrhoea, unexplained weight loss or presence of blood in stool. Barium enema is also considered as a diagnostic tool as it helps to diagnose conditions such as cancer, Hirschsprung’s disease (birth defect characterised by missing nerve cells in the large intestine), inflammatory bowel diseases and a volvulus (twisting of intestine loop).

Barium enema is usually performed by a radiology technician or radiologist. It is done in an x-ray room. Barium itself is a contrast medium which will be reflected on x-ray. It is a white chalky substance mixed with water and is not a radioactive substance. This barium mixture covers the lining of the colon and any trouble along the structure passed can be seen in images.

During barium enema, the barium liquid is injected into the rectum through a lubricated enema tip. A small soft tube is inserted a few centimetres through the anus and into the rectum for barium liquid to enter. Patients may be given medication to prevent involuntary bowel movements before barium enema is performed. Once the barium passes through the tube, some may feel cramping or urge to have bowel movement but it is important to make sure the barium does not leak out by trying to keep the muscles in the bottom tight. This will prevent the barium enema from flowing out but it is normal if there are some leaks. Patients may be asked to hold breath and move around turning side to side to help spread the barium along the bowel. Air may be pumped along with the barium to help cover all parts of the colon. Radiology technician or radiologist may even press on the stomach area to move the colon into a better position for x-rays. After x-rays images are obtained, barium enema procedure is considered fully done and patients are allowed to release the rest of the barium in the restroom.

To get the best images and to ease the procedure, the colon needs to be completely empty. Specific instructions will be given by doctors. Among the common instructions are that patients need to have a special diet such as soft food or clear liquid and avoid solid type food a few days before the procedure. Patients need to fast after midnight at the night before an exam and may need to take laxative to completely empty the colon. If patients do have usual medications such as prescription drugs, over-the-counter drugs or supplements, they need to ask their doctor if they can take it on the day of the procedure.

Now that you know what is usually prepared before and what to expect during the procedure, what’s left now is what happened after the barium enema procedure. Over the next few days, patients are advised to drink plenty of fluid and to eat food high in fibre as this helps flush out all barium and to regulate bowel movements. Patients might also be prescribed laxative or an enema. It is common to have white stool or grey one for a few days. This is normal and marks barium leaving the body.

Barium enema is generally safe but complications are possible such as severe constipation, inflammation or tear in the colon. However, complications are rare. A positive result of barium enema means radiologists do find abnormality in the colon. This alone may need further tests such as colonoscopy or biopsy. Barium enemas are not carried out very often since alternatives such as colonoscopy or CT-scan are usually preferred and need less preparation. Even so, barium enema is still a useful tool especially in healthcare facilities with limited resources. Plus, it is indeed an affordable procedure compared to colonoscopy or CT-scan. Do have a talk with your doctor if you are unsure why you are getting a barium enema. Doctors usually choose ether barium enema or colonoscopy depending on suspected diseases.

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John K. McGaha

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