Barium Enema (Lower GI (gastrointestinal) Series, Lower GI Exam)
X-ray of the large intestine after a barium enema.
X-ray of the large intestine after a barium enema.
The basics

A barium enema is a diagnostic test that uses X-ray images to detect abnormalities of the large intestine. The colon is filled with a contrast material that contains barium, which coats the inside of the intestine and blocks X-rays in order to allow the structures of the large intestine to be seen on X-ray films.

Barium enema can be used to diagnose conditions such as inflammatory bowel disease, narrowing in the intestine, and pockets or sacs in the intestinal wall. It may also be used to explore possible causes of abdominal pain, unusual bowel habits or other intestinal problems, and to screen for colon polyps or cancer.

It is recommended that people aged 50 or above be screened for colon cancer every 5 years (your doctor will recommend whether you should have a barium enema or other screening tests).

Risks and precautions

Barium enema is usually a straightforward and safe procedure. However, there are some risks of complications or side effects, including:

  • infection
  • inflammation
  • perforation of the bowel (where part of the bowel breaks open; this is very rare)
  • rectal bleeding
  • severe abdominal pain
  • severe constipation or obstruction

Get immediate medical assistance if you experience any of these complications or side effects. As with any test involving X-rays, a barium enema is associated with a small amount of radiation exposure.

It is important that you understand all the risks of complications and side effects of the test, and what you or your doctor can do to avoid them. Make sure that your doctor is aware of all your concerns.

During the test

This test is conducted by a technician in a hospital setting and it often takes about 30 to 45 minutes.

You will be dressed in a hospital gown and asked to lie on the X-ray table. An X-ray will first be taken to ensure that your bowel is clean. A technician will then insert a barium enema tube into your rectum to fill your large bowel with the barium contrasting agent. You should gently contract your anus muscles against the tube so that the barium contrast is held in place. Taking slow and deep breaths may help with relieving any discomfort.

Your doctor will observe the flow of barium contrast dye through the colon on a monitor. After the barium contrast dye fills the colon, you may be asked to turn to different positions so that X-ray images may be taken from different angles. After the test is complete, the enema tube will be removed along with most of the barium, and you will be taken to a toilet to expel the remaining barium. Additional X-rays may be taken after this point.

Before the test

It is important that you fully understand what the test involves beforehand. Ask your doctor to explain the risks, benefits, and drawbacks of the test, and don't be shy to probe further until you are comfortable with your doctor's responses.

It is important to tell your doctor if you are pregnant, have any allergies, or have recently had an upper digestive barium test (such as a barium swallow, where you swallow a barium mixture and X-rays are taken of your upper digestive system).

You will be put on a clear liquid diet about 1 to 3 days before the test to completely clean out your large intestine. You should drink large amounts of liquids and possibly take a few laxatives on the day before your test. You may also be asked to use an enema to further clean out your intestines. These procedures are very important because fecal materials can interfere with the test results.

If you are taking any prescription or over-the-counter (non-prescription) medications, supplements, or herbal products, make sure you inform your doctor or pharmacist. Ask them whether it is necessary for you to stop taking any of these medications and products before the test. It is also important to tell them if you have allergies to certain medications or have certain medical conditions.

Plan to have someone drive you home after the test.

After the test

You may resume your regular daily activities after this test. It is important to drink plenty of water or use laxatives (as recommended by your doctor) after the test since the barium preparation has a tendency to cause constipation. You may have light-coloured stools for a few days after the test.

A radiologist will review the X-ray images and compose a report for your primary care doctor, who will review the results with you. Your doctor may order additional tests if you have an abnormal result.

X-ray of the large intestine after a barium enema.
X-ray of the large intestine after a barium enema.

Medical Disclaimer

The information provided is for Canadian residents only. The contents are for informational and educational purposes only and are not a substitute for medical advice, treatment and diagnosis. The information is meant to educate you on health related issues. Always discuss the information with your Physician or other qualified health care professional ("Physician") before acting on it. Never disregard or delay acting on any advice given to you by your Physician because of something you have read on this site. Always seek the advice of a Physician regarding any questions you have about your medical symptom(s), condition(s) and treatment(s).