Imaging
Barium Enema
A barium enema is an X-ray test where barium liquid is passed into the bowel through the back passage to outline the large bowel on X-rays.
Quick answer
Barium Enema: what it is and what the results mean
A barium enema is an X-ray examination of the large bowel (colon and rectum). Barium liquid, and often some air, is introduced through the back passage so the lining of the bowel shows up clearly on X-ray images.
- Why it is done: It has largely been replaced by colonoscopy and CT colonography, but may still be used to investigate changes in bowel habit, bleeding, pain or suspected narrowing, diverticular disease or tumours when those tests are unsuitable.
- Understanding results: The radiologist reports the outline of the bowel wall, looking for polyps, narrowing, pouches (diverticula), inflammation or tumours.
What it is
A barium enema is an X-ray examination of the large bowel (colon and rectum). Barium liquid, and often some air, is introduced through the back passage so the lining of the bowel shows up clearly on X-ray images.
Why it is done
It has largely been replaced by colonoscopy and CT colonography, but may still be used to investigate changes in bowel habit, bleeding, pain or suspected narrowing, diverticular disease or tumours when those tests are unsuitable.
What to expect
You take laxatives beforehand to empty the bowel. During the test a soft tube is placed in the back passage and barium (and air) is passed in while X-ray pictures are taken and you change position. It takes around 30–45 minutes and can feel bloated and crampy.
Understanding the results
The radiologist reports the outline of the bowel wall, looking for polyps, narrowing, pouches (diverticula), inflammation or tumours. Abnormal findings usually lead to colonoscopy or specialist referral.
Good to know
Risks and limitations
It uses X-ray radiation and can cause temporary bloating, cramps and pale stools. It cannot take tissue samples, so abnormal areas often need a colonoscopy afterwards. It is avoided if a perforation is suspected.
Education and reference only. This explains the test in general terms and is not medical advice. Always follow the specific instructions from the team arranging your test, and discuss your results with your clinician.
Answers
Barium Enema: frequently asked questions
Is bowel preparation really necessary?
Yes. Any stool left in the bowel can hide or mimic abnormalities, so following the laxative and diet instructions carefully is essential for a clear, accurate test.
Why might I have this instead of a colonoscopy?
Most people now have colonoscopy or CT colonography. A barium enema may be chosen if those are not possible or not tolerated, but it cannot remove polyps or take biopsies.
Related tests
Other imaging investigations
Sources
Where this is drawn from
- NHS — Tests and treatments
- NICE — diagnostic guidance
- Royal College of Radiologists / relevant professional body
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