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Barium Enema

Barium enema is a diagnostic procedure that uses X-rays to assess for abnormalities of the large intestine including the colon and rectum. The contrast material containing barium outlines the lining of the colon and rectum to show a clear view on the X-ray image.

There are two types of barium enemas:

Single contrast study, in which the colon is filled with barium that outlines the intestine, and double contrast study in which the colon is filled with barium and is drained out leaving a thin layer of barium on the wall of the colon. The colon is then filled with air which provides a detailed view of its inner surface.


Barium enema is used to identify inflammation of the intestinal wall and monitor the progress of ulcerative colitis or Crohn's disease. It is also used to evaluate a variety of conditions which include:


Persistent abdominal pain.

Colon cancer and polyps.

Persistent diarrhea.


Celiac sprue (Small intestinal lining damage).

Lower gastrointestinal bleeding.

Anemia or unexplained weight loss.

Pre-procedural preparation.

Before performing a barium enema, your doctor will review your medical history. Inform your doctor if you are pregnant, allergic to latex or barium, or have recently undergone any colon related tests. A thorough cleansing of the large intestine is necessary before the procedure. You will be instructed to follow a clear liquid diet for 1 to 3 days before the test and just prior to it a cleansing enema is usually administered to enable a clear view.


The steps involved in performing the procedure of a barium enema include:

A preliminary X-ray of the lower intestine will be taken while you lie on the X-ray table.

Following this, a well-lubricated enema tube will be gently inserted into your rectum and the barium contrast material will be allowed to flow into the colon.

The inflated balloon on the tip of the enema tube will help the barium to stay in the colon until the test is completed. Your doctor may give you an injection to relieve cramping.

You will be instructed on turning to different positions so that X-ray images can be taken from all sides of the body.

During a double-contrast procedure, your doctor will drain the barium and fill the colon with air.

After the test your doctor will remove the tube, allow you to pass the barium and take some additional X-ray images.

Post-Procedural Care.

Following the procedure, you may use the bathroom or a bedpan to expel the remaining barium. You will be advised to drink plenty of liquids to flush out the barium from your system. You may have white stools for 1 to 2 days and some constipation which is easily treated by laxatives and increased fluid intake. Consult your doctor if these problems persist.

Risks and complications.

Barium enema is a safe procedure with minimal risks. Potential risks and complications include:

Severe constipation or obstruction.

Inflamed areas in the colon called barium granulomas.

Colon perforation due to pressure of the barium or air.

A barium enema produces clear images of the colon and helps diagnose many diseases and abnormalities. The procedure is generally safe. Be sure to follow your pre and postoperative instructions carefully.


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