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 Barium Enema (Stomach and Bowel Exams)


Also referred to as lower gastrointestinal (GI) tract radiography, called a lower GI, a barium enema is an x-ray examination of the large intestine. The appendix and a portion of the distal small intestine may also be included.

Who We Help

A physician may order a lower GI examination to detect:
  • benign tumors (such as polyps)
  • cancer
  • causes of other intestinal illnesses

The procedure is frequently performed to help diagnose symptoms such as:

  • chronic diarrhea
  • blood in stools
  • constipation
  • irritable bowel syndrome
  • unexplained weight loss
  • a change in bowel habits
  • suspected blood loss
  • abdominal pain

Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.

Contact Information

To book or follow up on the status of your appointment, please contact:

Mississauga Hospital or Queensway Health Centre:
Phone: 416-521-4069
Fax: 416-521-4014

Credit Valley Hospital:
Phone: 905-813-2731
Fax: 905-813-4418

How to Prepare for Your Procedure

  • Inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials.
  • Also let your doctor know about recent illnesses or other medical conditions.
  • On the day before the procedure you must not to eat, and to drink only clear liquids like juice, tea, black coffee, cola or broth, and to avoid dairy products.
  • After midnight, you should not eat or drink anything.
  • You must take a laxative (in either pill or liquid form) and use an over-the-counter enema preparation the night before the exam and possibly a few hours before the procedure. Just follow your doctor's instructions.
  • You can take your usual prescribed oral medications with limited amounts of water.

Resources for Patients & Their Families

What to Expect from Your Procedure

You will be asked to remove some or all of your clothes and to wear a gown.

You will also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always let their doctor or x-ray technologist know if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

How is the procedure performed?
The lower GI exam is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiology technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the barium enema.

The patient is positioned on the examination table and the technologist will then insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium and water into the colon. Air may also 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. 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 technologist know.

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 picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine

During the imaging process, you will be asked to turn from side to side and to hold different positions so that images can be taken from different angles. 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.

How It Works
The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.

Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.

What to Expect After Your Procedure
After the examination you can resume a regular diet and take orally administered medications unless told otherwise by your doctor. 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.