Barium enema

What happens during a barium enema?

Before the scan

Before having a barium enema, your consultant will ask you to make sure your colon is completely empty. This preparation typically starts a day or two before the exam. You may be asked to stick to consuming clear liquids such as water, broth, and clear juices, and to avoid solid foods. In some cases, patients might need to take a laxative in pill or liquid form to help empty their bowels. The goal is to ensure that there is no faeces left in the colon, which could interfere with the X-ray images.

When discussing your scan, please inform your consultant if there is any chance of being pregnant, as the procedure involves a small amount of radiation. Additionally, make sure you let the medical team know of any allergies, especially to iodine or latex, as these could cause an allergic reaction during the procedure.

On the day

On the day of the exam, you should arrive at the hospital wearing comfortable clothing. You might be asked to change into a hospital gown before the procedure begins.

During the scan

During the procedure, you will be asked to lie on your side on a specially designed table. A small tube is gently inserted into your rectum, through which the barium liquid is slowly introduced into your colon. In a double contrast barium enema, air is also introduced along with the barium. The air helps to expand the colon, allowing the barium to coat the lining more thoroughly and create clearer, more detailed X-ray images.

As the barium and air fill the colon, you may feel some discomfort or the urge to have a bowel movement. It's also common to feel the need to pass wind. However, it’s important to hold the barium and air in as much as possible until the radiologist has taken all the necessary X-rays. You may also be asked to turn into different positions and to hold your breath at times to help get the best possible images.

After the scan

Once the X-rays have been taken, most of the barium will be drained out of your colon through the tube, and the rest will be passed naturally during a bowel movement. You might experience a bloated feeling, cramps, or the urge to pass wind for a few hours after the exam. Your consultant will recommend drinking plenty of fluids to help flush your system while preventing constipation.

Your poo may look white or lighter in colour for a few days. This is totally normal and simply a result of the barium.

What are the common conditions that can be investigated with a barium enema?

Our consultants use barium enemas to investigate several conditions that affect the large intestine. Some of the most common ones include:

Diverticulosis and diverticulitis

These are small pouches (diverticula) that form in the wall of the colon, which can become inflamed or infected.

Colon polyps

Abnormal growths on the colon lining, which can sometimes develop into cancer if not removed.

Colorectal cancer

A type of cancer that begins in the colon or rectum. Early detection is crucial for effective treatment.

Inflammatory bowel disease (IBD)

Chronic inflammation of the digestive tract, including conditions like Crohn’s disease and ulcerative colitis.

Intestinal blockages

Obstructions in the colon that can cause severe pain and digestive issues.

Structural abnormalities

Unusual, twisted colon sections or structures that could cause symptoms like pain or abnormal bowel movements.

Preparing for a barium enema

For the best, clearest X-ray images, preparing for a barium enema in advance is essential. As mentioned previously, your consultant will advise you to try and keep your colon as empty as possible beforehand. Here are a few more preparatory tips that might be recommended:

Food and drink

A couple of days before your enema, you’ll need to switch to a clear liquid diet. This includes drinking only clear fluids such as water, broth, clear juices, and tea. Solid foods should be avoided.

Laxatives

Your consultant may prescribe a laxative in pill or liquid form to help empty your bowels, usually taken the night before the procedure.

Enemas

In some cases, an additional enema may be required the morning of the scan to make sure your colon is completely clean.

Medication

During your discussions beforehand, your consultant will discuss with you if you are currently taking any medication, and whether they need to be adjusted or temporarily stopped.

Allergies

Your consultant or radiologist will also talk you through any details around any of your known allergies, particularly to barium, iodine, or latex, to make sure you don’t have any allergic reactions during the procedure.

Who can have a barium enema?

Barium enemas are generally safe for most people. However, there are certain groups who might be advised against having the procedure. For example, pregnant women are generally not advised to have one, due to the small amount of radiation involved, which could pose a risk to the developing foetus. 

Patients with severe inflammation in the colon, such as those with an acute flare-up of inflammatory bowel disease (IBS), might also need to avoid barium enemas. As mentioned above, anyone with a known allergy to barium or other materials used during the procedure will usually pursue alternative imaging tests instead.

Recovering from a barium enema

Recovery from a barium enema is typically quick and straightforward. Most patients can return to their normal diet and activities straight after the procedure. However, it’s common to experience some minor side effects, such as bloating, cramping, or the need to pass gas, for a few hours after the scans.

To help your recovery and get rid of the barium in your body, you should continue to drink plenty of water and other fluids. This will help to prevent constipation and make sure any remaining barium is flushed out. If you do get constipated, your consultant can recommend or prescribe a mild laxative.

Understanding the barium enema X-ray

Your barium enema results are usually interpreted by a radiologist, who will review the X-ray images and provide a report to your consultant. In most cases, the results may be available immediately.

Sometimes it may take a few days for the full assessment and report to be ready.

If the result is negative

A barium enema test is considered negative if no abnormalities in the colon are detected.

If the result is positive

A barium enema exam is considered positive if abnormalities in the colon are detected. Depending on the details, you may need additional testing — such as a colonoscopy — so the abnormalities can be examined more thoroughly, biopsied or removed.

Your consultant will discuss your results and explain any next steps, which could include additional imaging tests, a colonoscopy, or even surgery, depending on the findings. If the barium enema shows any abnormalities, such as polyps, diverticula, or unusual shapes, you may need further testing or follow up treatment.

Why choose us?

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to fit your routine
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Support by the same compassionate clinical team from beginning to end
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about this procedure, call our dedicated team today.

Clinical review and sources

1. Barium enema, Cleveland Clinic
2. Barium enema, NHS
3. Barium enema, Mayo Clinic