What To Expect During a Lower GI Tract X-ray (Barium Enema)

The lower GI exam is usually done on an outpatient basis and is often scheduled in the morning to reduce your fasting time.

A radiology technician, radiology assistant and/or a radiologist will guide you through the barium enema.

You are positioned on the examination table and an X-ray film is taken to ensure the bowel is clean. After performing a rectal examination, the radiologist or technician will insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium and water into the colon. Air also may be injected through the tube to help the barium thoroughly coat the lining of the colon. In some circumstances, the radiologist or referring physician may prefer a water and iodine solution rather than barium. Next, a series of X-ray images is taken.

You must hold very still and may be asked to keep from breathing for a few seconds while the X-ray is taken to reduce the possibility of a blurred image. The technician will walk behind a wall or into the next room to activate the X-ray machine.

You may be repositioned frequently on order to image the colon from several angles. Some equipment will allow patients to remain in the same position throughout the exam.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

Once the X-ray images are completed, most of the barium will be emptied through the tube. The patient will then expel the remaining barium and air in the restroom. In some cases, the additional x-ray images will be taken.

Time Consideration

A barium enema is usually completed within 30 to 60 minutes.

Other Factors

As the barium fills your colon, you will feel the need to move your bowel. You may feel abdominal pressure or even minor cramping. Most people tolerate the mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the technician know.

During the imaging process, you will be asked to turn from side to side and to hold several different positions. At times, pressure may be applied to your abdomen. With air contrast studies of the bowel (air contrast barium enema), the table may be turned into an upright position.

After the examination, you may be given a laxative or enema to wash the barium out of your system. You can resume a regular diet and take orally administered medications unless told otherwise by your doctor. You may be able to return to a normal diet and activities immediately after the exam. You will be encouraged to drink additional water for 24 hours after the examination.

Your stools may appear white for a day or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need an enema or laxative to assist in eliminating the barium.

Limitations of Lower GI Tract X-rays

A barium enema is usually not appropriate for someone who is in extreme abdominal pain or who has had a recent colonic biopsy. If perforation of the colon is suspected, the enema should be performed with a water-soluble contrast solution.