Description of the test

A barium enema is a test in which X-ray pictures are taken of the colon. It involves placing a white liquid, called barium, into the rectum and colon. Barium is a contrast material that helps to enhance the X-ray pictures for clearer images. This test is done to visualize the anatomy of the colon and to diagnose diseases such as diverticulosis and colon cancer.

How often should this test be performed?

Most medical experts recommend that tests be done every 5 to 10 years in healthy people over the age of 50 to screen for colon and rectal cancer (colorectal cancer). Colorectal cancer is the fourth most common type of cancer in the United States. Barium enemas may be done earlier or more frequently if you have a family history of colorectal cancer or have had a previous precancerous polyp.

Why is this test performed?

Barium enemas are used to diagnose colon and rectal cancers, or inflammatory diseases. They are used to detect polyps (benign growths on the lining of the colon or rectum), diverticula (out-pouchings of the colon), and structural changes of the colon.

If you experience a change in your bowel habits, your doctor may order a barium enema to help evaluate your symptoms. For example, a barium enema may be necessary to explain symptoms such as diarrhea, blood in the stool, or abdominal pain.

Are there any risks and precautions I should know about?

You should not undergo a barium enema if you have a rapid heart rate, severe ulcerative colitis, toxic megacolon, or a presumed perforation in the intestine.

The barium enema does involve some radiation exposure. Exposure to radiation is minimized by standardizing the techniques used by the radiologist and radiation technologist.

Notify the radiology staff and your doctor ordering the test if you are allergic to barium or latex, have recently had a barium swallow procedure, or are or may be pregnant. Radiation exposure may be harmful to the fetus.

Occasionally, the barium can harden in the colon and cause severe constipation or obstruction. This is a rare complication and can be prevented by drinking extra fluids after the test and taking a laxative or enema if necessary. Rarely, barium granulomas (inflamed areas of the colon) can form.

Very rarely, the colon may be perforated during a barium enema and the contents of the colon may spill into the intestinal cavity. This complication can be treated with surgery and antibiotics.