A barium enema is a rectal injection of barium given to coat the lining of the colon and rectum. It is done before x-rays are taken in order to create better x-ray images. Barium is a milky fluid that absorbs x-rays.


Colon and rectum

Reasons for Procedure

A barium enema is done to enhance x-ray images. X-rays are taken of the colon and/or rectum to look for the following:

  • Abnormal growths, such as polyps or cancers
  • Ulcers
  • Diverticula (small pouches protruding through the wall of the colon)
  • Thickening of the lining of the colon or rectum

Risk Factors for Complications during the Procedure

  • Allergy to the latex balloon on the tip of enema tube (rare).
  • Severe rectal inflammation. Patients with active colitis should not have a barium enema.
  • Pregnancy. X-rays of the abdomen and pelvis should never be done during pregnancy.

What to Expect

Prior to Procedure

Your intestines must be empty before this test. Therefore, the day before your test, do the following:

  • Eat a clear liquid diet
  • Take laxatives
  • Take warm water enemas
  • Do not eat or drink anything after midnight

During Procedure:

You will put on a hospital gown and lie on an x-ray table.

  • The room will be darkened during the test.
  • You will hold your breath when x-ray pictures are taken.
  • You will change positions.
  • The x-ray table will be tilted to different positions.

Anesthesia – Usually none. In some cases, you may be given an injection to relax the rectum.

Description of the Procedure

A well-lubricated enema tube is gently inserted into the rectum. Barium is injected through this tube into the colon and rectum. A small balloon at the end of the tube is inflated to keep the barium inside. X-rays are taken. After x-rays are taken, the enema tube is removed, and you are shown to the bathroom to expel the barium.

For a double air contrast examination:

After expelling the barium, the enema tube is reinserted. A small amount of air is injected into the colon, and more x-rays are taken. The tube is removed. You are again shown to the bathroom to expel air and any remaining barium.

After Procedure:

  • You will be shown to the bathroom to pass the barium, and you may be given a laxative to help.
  • You will likely feel some mild to moderate abdominal cramping, which may require you to wait awhile before driving home.

How Long Will It Take? 1-2 hours

Will It Hurt? You may feel some discomfort when the enema tube is inserted. During the test, you may feel some discomfort, including bloating and severe cramping. You may also feel as if you need to move your bowels.

Possible Complications:

  • Inflammation of the lining of the rectum due to an allergic reaction to latex
  • Perforated rectum (serious, but rare)
  • Fetal malformation, if done during pregnancy

Average Hospital Stay – None

Postoperative Care:

  • You can return to your regular diet immediately following the test.
  • You can return to regular activities immediately following test (or as soon as you feel able).
  • You should drink lots of fluids because barium can cause dehydration.
  • You may be given laxatives to help pass barium, which can cause constipation.
  • Your stool may appear white or gray for 2-3 days after the test, due to the barium.


A radiologist will examine the/, x-rays. (In rare cases, if the x-rays are blurred, the test may have to be repeated.) Usually within a few days, your doctor will tell you the results. If results are abnormal, your doctor will recommend follow-up testing and treatment options.

Call Your Doctor If Any of the Following Occurs

  • Severe pain
  • Your doctor does not call with the results within 3-5 days


National Digestive Disease Information Clearinghouse

U.S. National Library of Medicine

University of Iowa Department of Radiology

The Merck Manual of Medical Information. Merck & Co., Inc., 2000

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