Barium enema: bowel prep for the procedure
Barium enema remains an important instrumental methods of diagnostics of diseases of intestines. It allows you to determine many diseases and pathological conditions, to make a differential diagnosis, to assess the results of therapy. Sometimes this diagnostic method doctors use when the impossibility of carrying out endoscopic study.
Barium enema is a procedure during which the bowel is filled with radiopaque substance is visualised by x-rays. In the area under survey is the entire colon, and some departments are fine. With barium enema can determine the shape and inner diameter of the colon, and to assess the presence of entities.
The quality of the examinations of the intestinal tract, and hence the further tactics of the doctor determined by how well trained the patient for barium enema.
About what it is and what is its algorithm, the patient should tell the doctor.
When should I think about the passage of the barium enema?
The study of the intestine is carried out by the doctor for the staging or diagnosis in case the patient for:
- The presence of blood in the stool.
- The presence of mucus in the stool.
- The appearance of pus in the stool.
- Alternating constipation and diarrhea, unstable stool.
- Persistent constipation or diarrhoea.
- Pain and discomfort in the anus.
- Frequent abdominal pain of unknown origin.
This study also can be useful when refining congenital malformations of intestine or suspected presence of neoplasm, and colonoscopy is impossible or unsatisfactory results.
In addition, the barium enema can be used after surgical treatment of pathologies of the intestine after resection, anastomosis groups to assess their function.
A colonoscopy is contraindicated in:
- Severe General condition of the patient.
- During pregnancy.
- The risk of perforation of the intestine.
- Allergic reactions to the contrast dye (very rare).
What is the training?
Patient preparation before the barium enema is a process consisting of several components and can be carried out at home subject to certain rules and algorithms:
- First of all, this diet. A few days prior to the proposed procedure should eliminate from your diet products leading to increased gas-formation: black bread, cabbage, potatoes, beans etc. to not eat after lunch on the day of preparation for the examination, usually prior to the study. If this drink could and should be all the time, including the day of the test (only preference is clean drinking water, teas, avoid coffee, carbonated beverages).
- The following paragraph contained in the memo in preparation for the procedure is an application prescribed by the attending doctor laxative, which will clean the bowel for the procedure a barium enema, which is a prerequisite for qualitative research. How what medication to take for the patient explains the doctor.
- A laxative can be replaced cleansing enemas. In order to adequately prepare the bowel for study in this way, the night before the procedure, you need to make at least two cleansing enemas (the volume should be at least 2 liters). The day of the test is another enema, but not later than 3 hours before the barium enema.
- If the patient is taking drugs that affect blood coagulation (NSAIDs, antiplatelet agents), he should inform the doctor as you may need to stop the medication a day before the expected barium enema. This decision takes only a doctor, after weighing all the pros and cons.
If the patient suffers from pain, it is necessary to discuss with your doctor the possibility of pain during the examination.
Preparation for barium enema bowel are increasingly carried out not with enemas, using laxatives, specially created for this purpose.
An example of such laxatives is Fortrans (another trade name of this tool ─ lavacol). Available in sachets with powder for preparation of solution.
The action of the drug based on the increased osmotic pressure of intestinal contents, resulting in the cavity of the intestine directs the fluids.
The algorithm of preparation for barium enema bowel can be found in the instructions to the drug or ask your doctor. This usually dissolve contents of package in a glass of drinking water. For complete preparation for barium enema you will need to drink about 3 liters of a solution during the day for 18-20 hours before the study.
Be wary of Fortrans should be used in patients with kidney diseases, arrhythmias. In addition, during the reception of this tool, it is important not to dehydration, drink plenty of fluids as osmotic laxatives can cause electrolyte imbalance.
What happens during the procedure?
The whole procedure takes about 30 minutes, but can last about an hour. The patient is asked to partially undress and lie on a special table.
Then, with the help of an enema into the intestine slowly injected contrast dye, and take x-rays. When the contrast reaches the lumen of the cecum, a barium enema is usually done and the patient is asked to empty the bowel. After this examination continues, logged areas, which have preserved the contrast, and what is not.
For better visualization, the radiologist can use the technique of double contrast. This means that after emptying of the barium from the intestine of a mixture of intestine filled with air. While the shots appear clearer intracavitary education or ulcers of the intestinal mucosa.
In any case, the key to conducting a quality examination and obtaining diagnostically meaningful results lies in thorough preparations. The more responsible the patient will come to that, how to prepare for barium enema bowel, the better the result.