Definition:

Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.

Indication:
A barium enema is done to: Identify inflammation of the intestinal wall that occurs in inflammatory bowel diseases, such as ulcerative colitis or Crohn's disease. A barium enema also may be used to monitor the progress of these diseases. Detect problems with the structure of the large intestine, such as narrowed areas (strictures) or pockets or sacs (diverticula) in the intestinal wall. Help correct a condition called ileocolic intussusception , in which the end of a child's small intestine protrudes into the large intestine. Evaluate abdominal symptoms such as altered bowel habits, anemia, or unexplained weight loss

Preparation:
The preparation for a barium enema usually involves a very thorough cleansing of the large intestine, because the colon must be completely clear of stool and gas. Even a small amount of stool can affect the accuracy of the test. For 1 to 3 days before the test, pt. will usually be on a clear liquid diet. On the day before the test: pt. should drink very large amounts of noncarbonated clear liquids, unless your doctor has advised you not to. pt. will then take a combination of laxatives to empty your intestines. pt. may be asked to take a tap water enema to clean any remaining stool from your colon. On the day of the test, pt. may need to repeat the enema until the liquid that passes is free of any stool particles.

Procedure:

The test usually takes 15 to 20 minutes, but pt will probably be in the radiology department for approximately 30 to 45 minutes. patient will lie flat on back on the xray table and an x-ray will be taken. pt. will then be told to lie on side. The health care provider will gently insert a well-lubricated tube (enema tube) into the rectum. The tube is connected to a bag that holds a liquid containing barium sulfate. The liquid is a type of contrast material that highlights specific areas in the body, creating a clearer image. The barium flows into the colon, and eventually passes out of the body with stools. A small balloon at the tip of the enema tube may be inflated to help keep the barium inside the colon. The health care provider will monitor the flow of the barium on an x-ray fluoroscope screen, which is like a TV monitor. There are two types of barium enemas: Single contrast barium enema uses barium to highlight the large intestine. Double contrast barium enema uses barium, but also delivers air into the colon to expand it. This allows for even better images. pt. will be asked to move into different positions and the table will be slightly tipped to get different views. At certain times when the x-ray pictures are taken, pt. will hold breath and be still for a few seconds so the images won't be blurry.

Post-procedure:
The enema tube will be removed after the pictures are taken. pt. will be given a bedpan or helped to the toilet to empty bowels and remove as much of the barium as possible. One or two x-rays may be taken after use the bathroom.

Complications:
Complications are when problems occur during or after the procedure. It's very rare, but pt. may have a reaction to the bowel cleansing preparation. This could include dehydration and the loss of too many salts from body, which can cause pt. to collapse or have a fit. During the test, there is a very small chance that bowel may be damaged or perforated. For this reason, pt. won't be offered a barium enema if pt. may already have an inflamed or weakened bowel wall.

Definition:
A Barium meal is a radiographic examination of the stomach and duodenum using barium sulphate suspension as contrast medium.

Indication:
Dyspepsia Unexplained weight loss Abdominal masses Upper GI tract haemorrage or iron deficiency anaemia Assessment of perforation and or post-surgery Gastrointestinal reflux

Preparation:
On the day before appointment pt. should keep to a light diet. This means avoiding foods which contain a lot of fiber, such as fresh fruit, salads, vegetables and bran. It is important that stomach is completely empty for this examination. pt. do not have anything to eat or drink for 6 hours before appointment time.

Pre-procedure:
pt. will be asked to change into a hospital gown and to remove any jewellery, hair clips, or clothes containing metal that will be within the x-ray field. pt. may also be asked to remove dentures.

Procedure:
The procedure usually lasts about 20 minutes..

Pt. will give an injection to relax the stomach, then ask him\her to swallow the fizzy powder which creates gas in the stomach. This will make pt. want to burp. Then ask pt. to drink the white liquid barium. Pt. will then lie down on a couch while x-ray pictures are taken, ask pt. to roll around into lots of different positions quite quickly so that picture can take.

Post-procedure:
A barium meal takes approximately half to one hour. Normally, people can resume their daily activities afterwards, although pt. may want to take it easy for the rest of the day. He\she can begin eating normally again. Pt. Make sure drink at least three litres of fluid each day for the next few days to flush the barium through system. stools will be light colored for one to three days. pt. should let the doctor know if he\she don't have a bowel motion within three days. The results of the test will be sent to the doctor who referred pt. for the test. A follow-up appointment will be made to discuss them with pt.

Complications:
Barium examinations are safe tests, but complications can sometimes occur. These may include: If a section of the digestive tract has an undiagnosed break or split (perforation), the barium meal may leak into the abdominal cavity. If the bowel is obstructed, the barium can become impacted. The barium can lodge in the appendix and cause appendicitis. There may be side effects (such as blurred vision) from the drugs used during the test. It is possible to accidentally breathe in the barium meal instead of swallowing it (this is very rare).