A Small Bowel Follow Through exam is a procedure performed by using a real-time form of x-ray called fluoroscopy. It is safe, noninvasive and may be used to help accurately diagnose bowel disease, obstructions, polyps, cancer and other symptoms.

Prior to the procedure, the patient drinks a liquid that contains barium or an iodine-based contrast, a contrast material that enhances x-ray images. As the contrast moves from the stomach into the small intestine, the radiologist will use an x-ray machine to look for any abnormalities. Although the procedure can be performed by itself, it is often done after an Upper Gastrointestinal (GI) fluoroscopic study of the esophagus, stomach and the section of the duodenum just beyond the stomach.

When would I get a Small Bowel Follow Through?

Your medical provider may recommend a small bowel follow through in order to assess the small intestine for abnormalities in size and shape. Small bowel follow through may also  evaluate how waste matter moves through it. It also may be performed to diagnose conditions such as:

  • Crohn's disease
  • small bowel obstruction
  • inflammatory bowel disease
  • abnormal masses or polyps
  • cancer of the small intestine
  • complications related to surgery on the abdomen or bowel.

What Will I Experience?

Before the imaging exam begins, you will be asked to drink two or more large cups of contrast material. The technologist will situate you on the x-ray table and position the x-ray machine above your abdominal area.

Once the contrast reaches your small intestine, the radiologist will observe its flow via fluoroscopy. Spot x-rays will be taken of any significant abnormalities.

You will continue to drink the contrast material throughout the exam to ensure that the radiologist can sufficiently examine the full length of the small intestine. You may be asked to lie on your right side between x-rays in order to encourage fluid to pass from the stomach into the small intestine. As the contrast reaches the end of the small intestine, the radiologist may need to press on the lower right portion for better visualization of the abdomen.

Once the contrast has reached the colon, you will be asked to use the bathroom. You will then receive a single additional x-ray in order to provide a general picture of how the contrast is distributed within the small and large intestines.

The contrast material is ingested in the form of a thick, chalky white drink or a clear thin liquid that is usually flavored to make it more palatable. You may feel some bloating and nausea from drinking it. You may also experience some discomfort from having parts of your abdomen compressed during the examination.

The duration of the examination depends on the amount of time it takes for the contrast to pass from the stomach to the large intestine. Typically, a small bowel follow through study takes about one to two hours.