LOWER GI SERIES (BARIUM ENEMA)

A lower gastrointestinal, or GI, series is a moving x-ray film of the large intestine, also known as the colon. In order for the colon to show up on x-rays, the GI tract must be coated or filled with a solution that contrasts with the surrounding tissues. This solution, called barium, is a white, chalky substance that makes the colon appear bright white. Barium helps to show the shadows and reflections of the intestines, and any abnormal or blocked movement.

This test is done to evaluate:

altered bowel habits
lower abdominal pain
blood, mucus, or pus in the stool
non-cancerous tumors, such as polyps
cancer or inflammatory disease and
obstructions or structural changes in the colon

It is frequently used to find the cause of chronic diarrhea, blood in stools, constipation, irritable bowel syndrome, unexplained weight loss, a change in bowel habits, or suspected blood loss.

The colon must be clear for a barium enema. Instructions for emptying the colon may vary, but usually include the following:

avoiding foods and dairy products for 24 hours before the test
drinking only clear liquids, like juice, tea, black coffee, cola, or broth, for 24 hours before the test
drinking at least 5 large glasses of water during that 24 hour period to avoid dehydration
taking a laxative (in either pill or liquid form) and an over-the-counter enema the night before the test
avoiding anything by mouth after midnight the day of the test and
taking another enema at home the morning of the test

A regular x-ray is taken first to make sure the intestines are free of stool. The examiner then slowly inserts a mixture of barium and water into the colon through a lubricated tube in the rectum. To help the barium thoroughly coat the lining of the colon, air may also be injected through the tube. The examiner may ask you to change positions frequently while the flow of barium is being filmed. Various still x-rays will also be taken. At times, pressure may be applied to your abdomen or the table may be tilted to get different views.

As the barium fills the colon, you may have abdominal pressure or mild cramping. These common discomforts are usually easily tolerated. You will also feel like you need to have a bowel movement. It is important that you try to contract the rectum to keep the barium in. The enema tip is specially designed also to help you do that.

The test typically takes 30 to 60 minutes. When it is finished, most of the barium is drawn back into the bag. You will be directed to the restroom to expel the rest of the barium and air. When you return, x-rays of the empty colon will be taken to make sure the intestines are clear.

You should be able to return to your normal diet and activities immediately after the test. Stools may appear white for a day or so, as the barium is cleared from your system. Some constipation may also occur.

A barium enema test is relatively safe. However, there is a slight risk of puncturing the colon or of having an inflammatory reaction to the barium. Call your healthcare provider, if you do not have a bowel movement for more than two days after the test or you are unable to pass gas from the rectum. You may need an enema or laxative to help get rid of the barium.

This test should not be performed on pregnant women or people with severe active colitis, or a suspected rupture of the colon.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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