A barium enema is an x-ray exam that can detect changes or abnormalities in the large intestine (colon). The colon is also known as the lower gastrointestinal tract (lower GI). It can often provide enough information to avoid more invasive procedures such as colonoscopy. If results are inconclusive, another option you can discuss with your medical provider is a virtual CT colonography study.

An enema is the injection of a liquid into your rectum through a small tube. This is performed by using a real-time form of x-ray called fluoroscopy.

To do a barium enema, you swallow a chalky white substance known as barium. It’s often mixed with water to make a thick drink that looks like a milkshake.

When would I get a Barium Enema?

Barium enemas are used to diagnose disorders of the large intestine, colon and rectum, such as colonic tumors, polyps, diverticula and unexplained weight loss or anemia. Your medical provider may recommend a barium enema to be appropriate in order to detect:

  • benign tumors, such as polyps
  • cancer
  • inflammatory bowel disease also known as ulcerative colitis
  • Hirschsprung disease (a blockage of the large intestine) in children.

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.

What Will I Experience?

On the day before the procedure you will likely be asked 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. For adults, but not usually in children, it is important that your colon be completely empty for the procedure. 

The patient is positioned on the examination table and an x-ray film is taken to ensure the bowel is clean. After performing a rectal examination, a small tube will be inserted into the rectum and begin to instill 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. A series of x-ray images is then taken.

The patient may be repositioned frequently in order to image the colon from several angles. Some x-ray equipment will allow patients to remain in the same position throughout the examination.

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. 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.

A barium enema will take approximately 30 to 60 minutes to complete.