Barium Enema, Double-Contrast

What is a double-contrast barium enema?

A double-contrast barium enema is a procedure that uses X-rays, barium, and air to examine your large intestine (colon). Barium is a liquid that can be seen on X-rays.

A double-contrast barium enema is different from a standard or single-contrast barium enema, which uses barium without air.

This procedure is also called an air contrast barium enema, lower gastrointestinal (GI) exam, or lower GI.

When is it used?

This procedure is used to look for problems in the large intestine and rectum (bowels), such as:

• diverticula (weak areas or pouches in the wall of your intestine)
• polyps (growths inside the bowel)
• inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
• cancer

Instead of this procedure, other procedures may include a colonoscopy. A colonoscopy is an exam of the colon with a slim, flexible, lighted tube.

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Tell your provider if you have any allergies to food or medicine.
• Because the large intestine needs to be empty, you will have a special diet for a day or two before the exam. Follow your healthcare provider's instructions for what you should or should not eat or drink before the procedure.
• Your provider may ask you to take an enema or medicine to clean out your bowels 1 to 2 days before the procedure.
• Wear loosely fitting, comfortable clothes that are easy to get in and out of.
• Follow any instructions your healthcare provider may give you. Ask any questions you have before the procedure. You should understand what the healthcare provider is going to do.

What happens during the procedure?

During the test, you will lie on an X-ray table. After an X-ray is taken to make sure that your bowels are free of stool, the technologist will insert an enema tube into your anus. The barium solution will be passed through an enema tube into your rectum and colon. The barium will be allowed to drain out, leaving a thin outline of barium on the colon lining. Then some air will be carefully pumped into your colon and X-rays will be taken from several different angles.

You may have some cramps or an urge to have a bowel movement during the test. Take long, deep breaths through your mouth to relax. Also try to squeeze the anus to keep the barium in. The enema tube is specially designed to help you do that.

At the end of the test, the tube will be removed and you will go to the restroom to pass barium and air still left in your intestine. You will then return to the table for a final X-ray.

The procedure takes an hour or less.

What happens after the procedure?

The barium will pass as you have bowel movements over the next few days. You may have cramping until all the extra air has passed from your bowel.

You may feel weak and dizzy after the procedure.

Ask your healthcare provider:

• how and when you will hear your test results
• what activities you should avoid and when you can return to your normal activities
• how to take care of yourself at home
• what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• Rarely, you may have an allergic reaction to medicines used during the procedure.
• Rarely, you may develop an infection.
• Rarely, the wall of the intestine may tear if it is weak. If this happens, you may need surgery.

Every procedure or treatment has risks. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.