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Barium Enema

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The special x-ray examination of the digestive system is called as a barium enema. This test helps in outlining the digestive organs so that they show up clearly on the X-ray. A barium enema can be used to outline the colon and rectum.

What is Barium?

The liquid contrasting substance that is inserted into the body through the anus contains barium sulfate. It coats the colon and helps detect any abnormalities or changes in the large intestine or colon on an X-ray.

What is Barium Enema?

Barium enema is the procedure where the white liquid is passed into the colon through the anus with the help of a tube. The X-rays are blocked by the barium leading to appearance of clear picture of the colon.

There are two types of barium enemas:

  • Single-column barium enema: In this test, the colon is filled with barium outlining the intestine. This helps in outlining the shape and condition of the colon.
  • Double-contrast barium enema: Also called as air-contrast barium enema. In this test the colon is filled with barium, which is drained out. This leaves a thin layer on the colon wall. Air is then inserted into the colon that helps in expanding the colon. This helps in giving clear and better X-ray images of the strictures, diverticula as well as any inflammation in the colon.

Why is a Barium Enema Performed?

Barium enema is performed to examine and investigate:

  • •Problems of the colon like polyps, colitis, tumors, diverticula or narrowing of the colon
  • •Inflammatory bowel disease, ulcerative colitis or Crohn’s disease
  • •For correction of a problem in young children where the small intestine protrudes into the large intestine called as ileocolic intussusception
  • •Evaluation of the causes for blood in stools, unexplained weight loss, anemia, etc.

Are There Any Risks Involved?

There are a few risks involved with barium enema. These risks include inflammation of the tissues if the tip of the enema catheter or tube penetrates the colon wall. It may even cause peritonitis, which is a generalized infection of the abdominal cavity. Some suffer from a tear in the wall of the colon that needs surgical intervention.

How Do I Prepare for Barium Enema?

Before the test is performed, one needs to clean their bowels. In order to do this, one has to avoid eating anything 24 hours before the exam. One has to limit their liquid diet to just clear liquids like water, broth or clear carbonated drinks. Tea or coffee without milk is also allowed. The night before the exam the doctor may ask you to take a laxative to help clear the bowels. The aim is to clear the bowels of any stools that may obstruct the view of the colon.

Diabetics need to ask their doctor regarding their diet and insulin medications before they undergo a barium test.

How is a Barium Enema Given?

One will be asked to change into a hospital gown. Then, they will be made to lie down on an X-ray table. One may be asked to turn over to their side, so that the enema tube can be inserted through the anus. The barium will then flow into the colon and the flow will be monitored with the help of a fluoroscope.

Many find the test a little discomforting and painful. Some may even have the urge to pass bowels. However, one has to try and hold it in as the barium has to remain inside the colon. The technologist will continue to take X-ray images.

After the procedure, one will be directed to the washroom. Make you expel as much as barium in the washroom. One will be directed back to the X-ray to take images after expelling the barium.

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After the Test

Once the test is complete and the required images taken, you need to drink as much water as possible. About 8-10 glasses water for two consecutive days. This will help in expelling of any remaining barium in the colon.

One may pass gray or whitish stools after the test for a few days. Some may suffer from constipation. In this case, they may be advised laxatives.

If one suffers from fever, dizziness, bloody stools, weakness or abdominal pain, they should immediately contact their doctor.

How Long Does the Barium Enema Test Last?

It takes just about an hour to complete a barium enema test. After the X-rays are taken, the images will be examined by a radiologist who will submit his report to the consulting doctor.


The result may be either positive or negative.  In case of positive, it will indicate abnormalities of the colon and one may be asked to undergo further tests. Negative indicates there are no abnormalities of the colon detected.

This was all about barium enema. This test does not require sedation and is carried out on an outpatient basis. Speak to your doctor regarding any queries before undergoing the test

Written by: Saptakee sengupta
Date last updated: March 13, 2015

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