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    Barium Studies

    Overview
    Procedure
    Results
    Possible Risks
    Limitations
     Where To Seek Treatment

     


    Contributed by Singapore General Hospital

    Overview

    These studies are specialised x-ray procedures using a solution containing barium to examine the gastrointestinal tract, namely the oesophagus, stomach, small intestine and large intestine.

    The most common studies are barium swallows, barium meals and barium enemas.

    Procedure

    Preparation

    Barium Swallows/Meals

    • Do not take any food or drink 6 hours before your appointment;
    • Avoid smoking during this period as well;
    • Continue all medications if you are on medication. However, if you are a diabetic and you are not taking any food, then please do not take your anti-diabetic drugs.

    Barium Enemas

    • low-residue diet is required before the examination. Food that may be taken during this period are: - clear soup, lean meat, steamed fish, boiled rice, boiled potatoes and porridge
    • Avoid vegetables, cereal, milk or creamy products, fruits, and oily/fatty food.

    Day Before Examination

    • Drink one large glass of fluid each hour, from 1pm to 9pm.
    • At 5pm, dissolve the laxative powder (Magnesium Sulphate) in a glass of water (lukewarm).Stir it well and drink.
    • At 9pm, take the 4 Bisacodyl tablets with a glass of water. DO NOT CHEW the tablets. Do not take tablets within 1 hour after taking an antacid and/or milk. Bisacodyl may cause abdominal discomfort and mild cramps.
    • Do not take solid food after mid-night, but carry on fluid intake till 12 hours before the procedure.

    The Morning Of The Examination

    • At 7am on the morning of your appointment, insert the suppository into the rectum. Allow adequate time (1/2 - 1 hour) for it to act before emptying your bowels.

    Note: Continue all medications if you are on medication. However, if you are a diabetic and you are not taking any food, then please do not take your anti-diabetic drugs.

    On Arrival

    You will be required to change into a hospital gown. A locker will be provided for your belongings but please keep your valuables at home.

    During the Procedure

    Barium Swallow

    • During the examination, you may be asked to stand and drink the barium solution. The radiologist will take x-ray films of your upper digestive tract.
    • Due to the nature of our work, some examinations may take longer than anticipated and we may not be able to keep strictly to schedule.
    • If you have any question about the examination, do not hesitate to ask the radiographer attending to you.

    Barium Meal

    • An injection is sometimes given to relax the muscles of the bowel. During the examination, the doctor will ask you to swallow some effervescent powder to outline the stomach better. Following that, the barium solution is drunk to outline the stomach and intestines. You will then be asked to turn in different positions on the x-ray couch while x-ray images are being taken.
    • Due to the nature of our work, some examinations may take longer than anticipated and we may not be able to keep strictly to schedule.
    • If you have any question about the examination, do not hesitate to ask the radiographer attending to you.

    Barium Enema

    • During the examination, you will be lying down on the x-ray couch. An injection is usually given. The radiologist then inserts a tube into the rectum and runs the barium solution through it.
    • After that, you will be asked to turn in different positions while x-ray images of the large intestine are taken. The radiologist may pump some air in to visualise the bowels better, and this may cause some abdominal discomfort.
    • Due to the nature of our work, some examinations may take longer than anticipated and we may not be able to keep strictly to schedule.
    • If you have any questions about the examination, do not hesitate to ask the radiographer attending to you.

    After The Examination

    Please do not change out of your hospital gown immediately after the examination. It may be necessary to do some additional views after the initial images were processed and reviewed.

    You may need to go to the lavatory after the procedure. You may expect to see white stools for the next 1-2 days, due to the barium solution.

    Once you are allowed to go back, please drink lots of fluid to avoid constipation.

    Results

    The radiologist will review the images and report the findings to your physician, who will then discuss the results with you on your next appointment.

    Possible Risks

    As with all procedures utilizing ionizing radiation, the radiation risks are present. However, the benefits of an accurate diagnosis far outweigh the risks.

    In rare cases, the barium suspension could leak through an undetected perforation in the lower gastrointestinal tract, producing inflammation in surrounding tissues.

    Even more rarely, the barium can cause an obstruction in the gastrointestinal tract, called barium impaction.

    Limitations

    A barium enema is usually not indicated for someone who is in extreme abdominal pain or had a recent colonic biopsy. If perforation is suspected, the study should be performed with iodinated solution, instead of a barium suspension.

    X-ray imaging is not usually indicated for pregnant women.

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