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During the exam
During a barium enema exam, you'll wear a gown but likely nothing else. Sedation isn't usually necessary.
You'll begin the exam lying on your side on an X-ray machine table. An X-ray will be taken to make sure your colon is clean. Then a lubricated enema tube will be inserted into your rectum. A barium bag will be connected to the tube to deliver liquid barium into your colon.
Barium is a metallic compound. The barium solution temporarily coats the lining of your colon. This provides a clear silhouette of the shape and condition of the inner lining of your colon on X-ray images. If you're having an air-contrast (double-contrast) barium enema, air will be inserted through your rectum to expand the colon and improve the quality of images.
The tube that's used to deliver the barium has a small balloon near its tip. When positioned at the entrance of your rectum, the balloon helps keep the barium inside your body. As your colon fills with barium, you may feel the urge to have a bowel movement. Abdominal cramping may occur as well. To relax, take long, deep breaths. Do your best to hold the enema tube in place.
You may be asked to turn and hold various positions on the exam table. This helps ensure that your entire colon is coated with barium and allows the radiologist to view the colon from various angles. The radiologist may press firmly on your abdomen and pelvis, manipulating your colon for better viewing on a monitor attached to the X-ray machine. He or she will likely take a number of X-rays of your colon from various angles. You may also be asked to hold your breath at times.
A barium enema exam typically takes about 20 to 40 minutes.
After the exam
After the exam, most of the barium will be removed from your colon through the enema tube. When the tube is removed, you'll be able to use the toilet to expel additional barium and air. Any abdominal cramping usually ends quickly, and you'll be able to return to your usual diet and activities right away.
You may have white stools for a few days as your body naturally removes any remaining barium from your colon. Because barium may cause constipation, it's important to drink extra fluids in the days following the exam. Your doctor may recommend a laxative if needed.
Check with your doctor if you're unable to have a bowel movement or pass gas more than two days after the exam or if your stool doesn't return to its normal color within a few days after the exam. This may indicate that some amount of barium remains in your colon.
- Barium enema examination. American Society of Radiologic Technologists. Accessed March 11, 2009.
- Lower gastrointestinal (GI) tract X-ray (radiography). Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?pg=lowergi. Accessed March 11, 2009.
- American Cancer Society guidelines for the early detection of cancer. American Cancer Society. Accessed March 11, 2009.
- Levin B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570.
- Colon x-ray: Defecography (DEF); barium enema; air contrast study (evacuative portography). In: Fischbach FT, ed. Manual of Laboratory & Diagnostic Tests. 7th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2004:732.
- Schilling McCann JA, ed. Diagnostic Tests. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2007.
