Lower gastrointestinal (GI) tract radiography, also called a Lower GI or Barium Enema, is an x-ray examination of the large intestine, also known as the colon. The appendix and a portion of the distal small intestine may also be included. The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium.
A physician may order a lower GI examination to detect:
- benign tumors (such as polyps)
- signs of other intestinal illnesses
The procedure is frequently performed to help diagnose symptoms such as:
- chronic diarrhea
- blood in stools
- 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.
How does the procedure work?
Fluoroscopy uses a continuous x-ray beam to create a sequence of images that are projected onto a monitor. When used with a contrast material, which clearly defines the area being examined by making it appear bright white, this special x-ray technique makes it possible for the physician to view internal organs in motion.
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. Barium or barium and air may also be injected through the tube. In some circumstances, the radiologist or referring physician may prefer a water and iodine solution rather than barium. Next, a series of x-ray images is taken. The patient may be repositioned frequently on order to image the colon from several angles. When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. Once the x-ray images are completed, the patient will then expel barium in the restroom. In some cases, the additional x-ray images will be taken. A barium enema is usually completed within 30 to 60 minutes.
What will I experience during and after the procedure?
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.
During the imaging process, you will be asked to turn from side to side and to hold several different positions. With air contrast studies of the bowel (air contrast barium enema), the table may be turned into an upright position.
After the examination, you can resume a regular diet and take orally administered medications unless told otherwise by your doctor. You may be able to return to a normal diet and activities immediately after the exam. 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.
Who interprets the results and how do I get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.
You should inform your physician of any medications you are taking and if you have any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
You can take your usual prescribed oral medications with limited amounts of water. The day before the exam remain on clear liquids all day drinking 8 oz. of water each hour. For your meals, you can drink sugar free drinks (no milk or creamer), clear broths, sugar free gelatin, and sugar free popsicles. You can pick up your prep and instructions from our Blue Ridge and Cary facilities.
Women should always inform their physician or x-ray technologist 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.