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A barium enema is a diagnostic test that uses X-rays and contrast agents, usually barium sulfate, to study the shape and function of the large intestine and rectum and thus detect possible intestinal problems such as diverticulitis or polyps, for example.
The barium enema exam can be performed in both adults and children and can be divided into simple barium enema, when only one contrast is used, and double-contrast barium enema, when more than one type of contrast is used.
To perform the exam, it is important that the person follows the doctor's recommendations, such as fasting and bowel cleansing so that the intestine can be properly visualized.
What is it for
The barium enema exam is indicated to investigate possible changes in the intestine, so the gastroenterologist can recommend its performance when colitis, intestinal cancer, intestinal tumors, diverticulitis, which is inflammation of the folds of the walls, are suspected of the intestine, volvulus which is characterized by twisted intestine, or presence of intestinal polyps.
In children, the indications for the barium enema exam may be chronic constipation, chronic diarrhea, bloody stools or chronic pain in the abdomen, in addition to being indicated as a form of screening for children who will undergo biopsy of the rectum due to suspected Hirschsprung syndrome, also known as congenital megacolon, in which there is an absence of nerve fibers in the intestine, preventing the passage of stool. Learn more about congenital megacolon.
Preparing for the barium enema exam
To perform the barium enema exam, it is important that the person follows some doctor's guidelines, such as:
- Fasting for about 8 to 10 hours before the exam;
- No smoking or chewing gum during fasting;
- Take a laxative in tablet or suppository form the day before to cleanse the intestines;
- Follow a liquid diet the day before the exam, as indicated by the doctor.
These cares are important because the intestine must be completely clean, without feces or gauze residues, so that it is possible to see the changes.
Preparation for barium enema in children over 2 years of age includes offering plenty of fluids during the day and giving milk of magnesium after dinner the day before the exam. If the exam was requested because of chronic constipation or megacolon, preparation is not necessary.
How the exam is done
The barium enema exam lasts about 40 minutes and is performed without anesthesia, which can make the person feel pain and discomfort during the exam. Therefore, some doctors prefer to request a colonoscopy because it also serves to evaluate the large intestine, being safer and more comfortable for the patient.
The barium enema exam is performed according to the following steps:
- Performing a simple X-ray of the abdomen to verify that the bowel is properly clean;
- The person is placed lying on the left side, with the body leaning forward and the right leg more in front of the left leg;
- Introduction of a rectal probe and the contrast agent, which is barium sulfate;
- The person is repositioned so that the contrast can be spread out;
- Removal of excess contrast and injection of air;
- Probe removal;
- Performance of several x-rays to evaluate the intestine.
During the examination, the person may feel like having a bowel movement, especially after the injection of air, and after the examination, they may experience swelling and pain in the abdomen and an urgent urge to have a bowel movement. It is normal for the person to have constipation for a few days and the stools to be white or gray due to the contrast, so it is very important to increase the consumption of foods rich in fiber, such as whole grains and fruits with skin, and to drink 2 liters of water per day.
In the case of children, this can also happen, so it is important for parents to give the child plenty of fluids after the examination.