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When a doctor may order a barium enema when they suspect a patient may have an abnormality in their intestines. The procedure is sometimes called a colon X-ray. It allows doctors to see inside the intestines and diagnose problems. The procedure is not complicated and fairly common. It is an out-patient procedure.

What is Barium Enema?

Why a Patient May Need a Barium Enema

A patient may need a barium enema for several different reasons. Doctors commonly order them when a patient is showing signs or symptoms of an intestinal problem. These symptoms include, 

Indications for Barium Enema

Preparing for a Barium Enema 

Before a doctor performs a barium enema, he will ask the patient

to prepare for the procedure. The colon needs to be empty for the procedure so that food residue is not mistaken for polyps or other abnormalities. Doctors may ask patients to: 

  • Follow a diet the day before the procedure
  • Fast after midnight
  • Take a laxative the day before the procedure
  • Use a home enema kit to clear out the colon
  • Stop taking certain medications before the procedure

During The Procedure

Before the procedure starts, the doctor will ask the patient to remove any jewelry and clothing. The patient will receive a gown to wear. A radiology technician and a diagnostic imaging physician will perform the procedure. During the procedure, the patient will lay on his side on a table. An x-ray will confirm that the colon is empty. The doctor inserts a lubricated enema tube into the patient’s rectum. A barium bag will deliver the barium into the colon. Patients may feel some pressure while the barium moves to the colon.

The doctor will ask the patient to turn and move into different positions. This allows the physician to see different angles inside the intestines. Patients may need to hold their breath and remain perfectly still during the procedure. The physician may also press on the patient’s abdomen and pelvis as they attempt to manipulate the colon for better views. A physician will take X-rays during the procedure and it typically only lasts 30 to 60 minutes.


Once the doctor removes the enema, patients can use the restroom to relieve themselves and remove the barium from their colon. Patients may experience some abdominal pain and cramping the day after the procedure. Constipation is also common during recovery and patients may even produce white stools. Doctors will often prescribe a laxative to help patients remove all the barium from their colons and to make recovery easier and faster.


Patients who have barium enemas do not usually have any complications from the procedure following the removal of the barium. In fact, most recover from the procedure within a week. Once the procedure is complete, the radiologist completes a report based on the findings of the enema and X-rays and sends it to the physician. A negative result means that there were no abnormalities found during the procedure. A positive result means there were abnormalities detected in the colon. If the result is positive, the physician may order more tests or may offer a diagnosis and treatment options.

Gastroenterology, Barium Enema

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