Barium enema

A barium enema is a test that allows your doctor to examine the lower part of your bowel.

During a barium enema, a white fluid called barium is used to outline the walls of the bowel and air is used to open the bowel up.

A barium enema is commonly ordered for people who have experienced altered bowel habits, lower abdominal pain, or who have passed blood, mucus or pus in their stools. It is done to make or confirm a diagnosis.

What do I need to do to prepare for this test?

Image of abdomen radiography with contrasted intestine

The bowel needs to be completely clean so the area to be examined can be seen clearly. Commonly you will be asked to take some tablets (laxatives) and a drink that you make up at home. You will be given a prescription to pick up this drink from a pharmacy. These both help to clear the bowel.

You will also be asked to eat a special diet and drink plenty of clear fluids for 24 hours before the test. Some people also require a small enema if they have been constipated.

What happens before the test?

You will be asked to remove all your clothing and underwear, and change into a hospital gown. It is advisable to remove all your jewellery and glasses. Use this opportunity to go to the toilet. 

What happens during the test?

Once in the room, you will be asked to lie on a special x-ray table. You will either be strapped to the table and the table will tilt during the test, or you will be asked to roll yourself into various positions throughout the test.

If it hasn't already been done, the doctor will start by examining your back passage with a finger. A well-lubricated tube will then be inserted, and the barium run in. Air will then be puffed in. This can cause some discomfort or cramping and the doctor may want to give you a small injection to stop this.

If you have glaucoma you must tell the staff, as a different type of injection will need to be used.

You may also feel the need to pass a motion, but if you tighten your bottom muscles around the tube, this will pass in a few minutes. Taking slow, small breaths will also help.

As each x-ray is taken, you will be asked to lie completely still and hold your breath. When the doctor is happy that enough pictures have been taken, the tube will be removed and you will be able to sit up slowly (you may feel lightheaded). Once you are feeling all right you will be allowed to go to the toilet.

What happens after the test?

This test usually takes 30 to 90 minutes. You will need to stay near a toilet for a while afterwards, as there will be some barium and air still inside you. You may even pass lumps of barium for a couple of days.

You should drink plenty of fluids for the next few days to flush the barium through your bowel. Hot drinks can be helpful if you experience any cramps. You can eat following the test, but it is best to start with something light. This test can be exhausting; so plan to have the rest of the day off and have someone available to drive you home.

The results of the test will be sent to the doctor who referred you, and a follow up appointment will be made for you to discuss them.

What are the risks?

  • Some people become light-headed due to the preparation for, and the stress of, the test. You may even faint, so it is very important to tell someone if you fell unwell. Usually sucking on a couple of barley sugars will make you feel better.
  • Barium enemas have been known to aggravate ulcerative colitis.
  • There is a very small risk of putting a hole in the side of the bowel.

Where do I go for a barium enema?

Barium enemas are performed at both hospitals as an outpatient and private radiology facilities. For both, you will require a referral from your general practitioner.

For further information and support talk to your doctor or contact the hospital or radiology centre where you are having the barium enema.

Credits: Health Navigator NZ, Jan 2015. Last reviewed: 20 Jan 2015