Barium Enema

What Is a Barium Enema Procedure?

A barium enema is used to coat the lining of the colon and rectum. It is done before X-rays are taken, in order to create clearer images of the lower intestine. A barium solution is given into the rectum. Barium (bare-ee-um) is a thick, milky fluid that absorbs X-rays.

You might also hear doctors refer to the barium enema test as a "barium X-ray", "lower GI series", "lower GI" or "lower gastrointestinal series".

Body Parts Involved

  • Colon
  • Rectum

Why does my child need a barium enema?

A barium enema is done to enhance X-ray images. The barium coats the lining of the colon and rectum and makes these organs, and any signs of disease in them, show up more clearly on X-rays. It also helps the radiologist (doctor who specializes in reading X-rays) see the size and shape of the colon and rectum. Your doctor uses these X-rays to diagnose problems in your child's large intestine. A barium enema can detect the following:

  • Abnormal growths, such as polyps or cancers
  • Ulcers
  • Diverticula (small pouches protruding through the wall of the colon)
  • Thickening of the lining of the colon or rectum
  • Other signs of intestinal disease or malfunction

What is it like to have a barium enema?

Prior to Procedure

Your child's colon must be empty for the barium enema procedure to be accurate. The day before the test, your child may be asked to prepare by taking some of the following steps:

  • Eat a clear liquid diet – for example, fat-free bouillon or broth, gelatin, water, or plain tea
  • Take laxatives
  • Take warm water enemas
  • Do not eat or drink anything after midnight

Your child's doctor may give other special instructions.

During the Barium Enema Procedure

Your child will put on a hospital gown and lie on an X-ray table. The room will be darkened during the test.

A well-lubricated enema tube is gently inserted into your child's rectum. Barium is injected through this tube into the colon and rectum. A small balloon at the end of the tube is inflated to keep the barium inside.

While the barium is inside, X-rays are taken. The X-ray table will be tilted to different positions. Your child will be asked to hold his or her breath at certain times so that the X-ray image will not be blurred by movement. Your child may also need to change positions as directed by the technician. Different positions give different views of the intestine.

A barium enema can be uncomfortable, but it is not painful. Usually anesthesia is not given. In some cases, your child may be given an injection to relax his or her rectum. Your child may feel some discomfort when the enema tube is inserted. During the test, your child might experience bloating and cramping, or feel like he or she needs to have a bowel movement. Your child is unlikely to have an accident, though. The tube used to inject the barium has a balloon on the end of it that prevents the liquid from coming back out. The barium is what causes that sensation of fullness and pressure in the abdomen. The entire procedure will take one to two hours.

After the barium enema procedure

After X-rays are taken, the enema tube is removed, and your child will be able to go to the bathroom. The X-ray technician sometimes also takes an X-ray of the empty colon afterwards. This is called a double air contrast examination. After the enema tube is reinserted, a small amount of air is injected into the colon. More X-rays are taken, and then the tube is once again removed. Afterwards, your child may return to the bathroom to expel air and any remaining barium.

Unless your child is an inpatient at the hospital for another reason, there is no hospital stay involved. However, your child will likely feel some mild to moderate abdominal cramping. He or she may want to rest or stay near the bathroom at the hospital for awhile before going home.

Your child can return to his or her regular diet immediately following the test. The same goes for regular activities; as soon as your child feels able to do them.

Have your child drink lots of fluids, because barium can cause dehydration. In addition, barium causes constipation, which is why your child may need a laxative. For up to two or three days after the test, your child's bowel movements may appear white or gray. This is also due to the barium, and no cause for alarm.

Are There Any Complications Associated with the Barium Enema Procedure?

  • Women who are or think they might be pregnant should not have X-rays of the abdomen or pelvis. There is a risk of harm to the fetus.
  • Patients with active colitis should not have a barium enema, as it can cause severe inflammation.
  • Rarely, a patient has an allergic reaction to the latex balloon on the tip of enema tube. Such a reaction would involve inflammation of the lining of the rectum.
  • Perforation (tearing) of the rectum or colon is a serious complication, but it is also rare.

When Will We Find Out the Results?

A radiologist will examine the X-rays. (In rare cases, if the X-rays are blurred, the test may have to be repeated.) Your child's doctor will normally tell you the results within three to five days. If the results are abnormal, the doctor will recommend follow-up testing and treatment options.

Get the Barium Enema Patient Procedure.

Learn about other Intestine Transplant Tests.