Barium Emenas
What is this examination used for?
A Barium Enema is used to look at the Large Bowel or Colon. A thin coating of a barium compound lines the inside of the colon, and X-rays are taken. Barium looks white on X-ray, and outlines any irregularity of the Bowel wall.
How is it done?
A barium powder is mixed with water to make about 600 mls of thick liquid which is stored in a clear plastic bag. The bag is connected to a tube which is smaller in cross-section than a finger.
The tip of the tube is lubricated and is inserted by the doctor into the rectum. Only 5 to 8 cms (2 to 3 inches) is inside the Rectum. Some tubes have a balloon around the tip which can be inflated and used to hold the tube inside the rectum.
The doctor then slowly lets the barium from the bag run into the Colon. Initially, there is little sensation, as the actual volume of liquid introduced is small. Gravity is used to flow the liquid around the colon, and the doctor will ask you to lie on your side, back or front to follow the natural loop of the colon.
Once the liquid is inside the Colon, the doctor will allow much of the fluid to flow back out into the bag, as the idea is to coat the lining of the bowel with barium to take the X-rays, not to fill the whole bowel with fluid.
The doctor then gently introduces air into the rectum from the bag. This is to force the walls of the colon apart so that any small irregularities of the bowel wall can be imaged by X-ray. At this stage you may feel uncomfortable for the first time, and feel you want to go to the toilet, as the natural response of the bowel when distended is to warn you that it is full and to try and contract. Don’t worry. It’s an unpleasant feeling, but should not be painful. If you experience pain at any time, tell the doctor.
Several X-rays are then taken. Again the doctor will ask you to roll around on the X-ray table to view all the twists and turns of the bowel. The X-rays are then processed and checked by the doctor, who may need to take some more.
After the test, much of the gas and liquid is allowed to flow back into the bag. The tube is then removed, and you can go to the toilet, which is close to the X-ray room.
Small Bowel Series
What is this examination used for?
A small bowel series is used to examine the small bowel; the part of the digestive tract between the stomach and the colon. A barium compound diluted with water fills the inside of the small bowel, and x-rays are taken. Barium looks white on x-ray, and outlines the bowel wall.
How is it done?
A thin barium liquid is swallowed, and passes from the stomach into the small bowel. The object of the test is to fill the length of the small bowel with barium. This means that several hundred mls of liquid may have to be swallowed. Don’t worry – we want you to swallow as much as possible, but we won’t force you to drink it so fast that you feel sick. After the liquid is drunk, you will be asked to lie on your right side, so the liquid leaves the stomach and passes into the small bowel.
The normal “transit time” through the small bowel is very variable, and may be between 45 minutes and several hours depending on how fast The Barium travels through the small bowel. If you experience pain at any time, tell the doctor or radiographer. The pain may help to localise areas of disease, so don’t hesitate in telling.
Several x-rays will be taken. The doctor may ask you to roll around on the x-ray table to view all the loops of the bowel. The x-rays are then processed and checked by the doctor, who may need to take some more.
Once the barium is through the small bowel and the pictures are taken, you will be allowed to go to the (nearby) toilet, as the liquid has reached the large bowel. Usually the capacity of the large bowel, and the ability of the large bowel to absorb water mean that diarrhoea is uncommon.
