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NHS Choices - How a barium enema is performed

(06/02/2014)

A barium enema is a routine procedure that takes around 30 minutes to do. You should be able to go home shortly after the test.

You can take a family member or friend with you, but they may not be allowed into the X-ray room. It is advisable that you bring someone with you to drive you home, as you may not be able to drive straight after the procedure.

Preparing for a barium enema

Before having a barium enema, your bowel should be empty of any stools to make sure clear pictures can be taken. Your doctor will advise you about the type of food you can eat the day before the test and you will be prescribed a strong laxative to clear your bowel. Follow the instructions carefully and stay at home the day before your test to avoid any inconvenience and to be as comfortable as possible.

If you are diabetic and take insulin or tablets, make sure that you carefully follow any instructions given by the hospital so that your blood sugar levels do not drop.

If there are no special instructions on the information sheet you have recieved, contact the radiotherapy department and seek their advice before starting the bowel preparation routine. Most hospitals will try to arrange a morning appointment if you have diabetes.

During a barium enema

You will be asked to lie on an X-ray table on your side, and a small soft tube will be gently inserted a few centimetres into your bottom (rectum). You may also be given an injection, usually of Buscopan, a drug that helps prevent spasm of the colon. Many radiologists give this injection routinely at the start of each barium enema procedure. Your doctor may not give you this injection if you have a history of heart disease or glaucoma.

The barium sulphate liquid is passed through the tube and into your colon, and the radiologist or radiographer will be able to see this on a television screen. You may be asked to lie in a number of different positions to help the flow of the barium liquid, and to get it to spread evenly along the wall of the colon. Air may also be pumped into the colon to expand it and push the barium sulphate liquid inside. This may feel a bit uncomfortable, like having trapped wind.

After the barium has been passed into the colon, a number of X-ray pictures will be taken from various positions. The X-ray table will rotate to put you in a standing position. You will be asked to roll onto each side to obtain the various pictures required. As the X-rays are being taken, you will be asked to hold your breath.

The test usually takes about 30 minutes. When the X-rays have been taken, the tube will be removed and you can then go to the toilet.

The test results will be sent to your GP within 14 days.

Does it hurt?

Having a barium enema should not hurt but may cause some discomfort. Some people experience cramp-like pain during and a short while after the procedure.

The procedure does involve a significant amount of moving and rolling on the table. If you are weak or have a condition that may make this difficult, let the imaging department know before having the bowel preparation. An alternative test may be more appropriate.

Some people also worry that they may not be able to hold the barium liquid and air in their bowel. Try to hold on to it by keeping the muscles of your bottom very tight. If you let go too soon, it may affect the X-ray images.

Some people leak barium fluid onto the X-ray table, but try not to worry too much about this happening.

Afterwards

You can normally eat straight away after the procedure. It is a good idea to eat fruit and vegetables and drink plenty of fluids for three days afterwards to avoid constipation, until your stools have returned to normal. After the procedure:

  • You will need to go to the toilet. It's a good idea to stay close to a toilet for the next few hours.
  • Your stools will appear white and discoloured for a few days. This is the barium liquid passing out of your system.
  • If you have a Buscopan injection, you will need to wait up to 30 minutes before you drive as it can blur your vision. It is best to take someone with you to drive you home.
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