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Lower GI Series / Barium Enema 

A Lower Gastrointestinal (GI) Series or Barium Enema test provides a series of X-ray images of the large intestine.  A barium enema can be used to screen for colon cancer and bowel diseases.  Prior to taking X-rays, barium, a chalky substance, and air are used to fill and expand the colon.  The barium reveals the bowel’s shape and position on the X-ray images.  A barium enema is an outpatient procedure that is performed at a doctor’s office or a hospital’s radiology department. 

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Your body absorbs nutrients and removes waste products via your digestive system.  Whenever you eat and drink, food travels through your digestive system for processing.  As water from the waste product is absorbed, the product becomes more solid and forms a stool or feces.  It is eventually eliminated from your body when you have a bowel movement.

After you swallow food, it moves through your esophagus and into your stomach.  Chemicals in your stomach break down the food into a liquid form.  The processed liquid travels from your stomach to your small intestine.  Your small intestine breaks down the liquid even further so that your body can absorb the nutrients from the food you ate.  The remaining waste products from the small intestine travel to the large intestine.

Your large intestine, also called the large bowel or colon, is a tube that is about 5 feet long and 3 or 4 inches around.  The lower GI tract is divided into sections, including the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, anal canal, and anus.  The appendix is located on the cecum, but it does not serve a purpose in the digestive process. 
The first part of the colon absorbs water and nutrients from the waste products that come from the small intestine.  As the colon absorbs water from the waste product, the product becomes more solid and forms a stool.  The large intestine moves the stool into the sigmoid colon, where it may be stored before being traveling to the rectum.  The rectum is the final 6-inch section of your digestive tract.  No significant nutrient absorption occurs in the rectum or anal canal.  From the rectum, the stool moves through the anal canal.  It passes out of your body through your anus when you have a bowel movement.

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Test Uses

A Barium Enema is most frequently used to screen for colorectal cancer and bowel diseases.  It is helpful for determining the cause of bleeding, pain, bowel obstruction, or changes in bowel habits.  The test may be modified for a Double-Contrast Barium Enema.  This test uses a fluoroscope to view inside the large intestine to provide a better view of the mucous membrane.

A barium enema is an outpatient procedure that is performed at a doctor’s office, an outpatient radiology center, or a hospital’s radiology department.  The test does not require sedation or anesthesia.  Preparation instructions for a barium enema generally consist of methods to empty or clean your bowel prior to the test including the use of laxatives, enemas, or a liquid diet.  Your doctor will provide you with specific instructions.
The Procedure

You will wear an examination gown for your barium enema.  You will lie on your side for the procedure.  An initial X-ray is taken prior to receiving the barium.

The barium will be gently inserted through a well-lubricated tube placed in your anus.  Barium is a substance that shows up on X-rays.  Air may be inserted to open the folds of your colon to provide a better view.  You may be asked to change positions during the procedure to enable different views. 

After a series of X-rays are taken, the enema tube is carefully removed.  You will go to the bathroom to eliminate as much as the barium as possible.  Then, a final series of X-rays are taken. 

The barium enema may cause temporary discomfort.  You may experience cramps, feel full, or as if you need to have a bowel movement.  An X-ray is a painless procedure.  It simply requires that you remain motionless while a picture is taken.  Your doctor will also discuss unexpected symptoms related to the test that may occur and a plan to address them.

A radiologist will read your X-rays and report the results to your doctor.  This process may take a few days.  Your doctor will contact you or schedule a follow-up appointment when the results are received.  If any abnormal results were found by your test, your doctor will discuss treatment plan options with you.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit