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Have You Had a Barium Enema?

 

I received several enemas growing up, but one thing I noticed was lacking as I went through some of the past messages, was any recollection of barium enemas.  I had one of these about two years ago when I was 28.  I'd like to relate my experience with that dreaded procedure.

I had been having stomach pains for about a month, including diarrhea so I finally made an appointment with my doctor.  After listening to my complaints and examining me, which included a digital rectal exam, he suggested that I have a 'lower GI series.'

I didn't fully understand what that meant until I got home and looked it up on the internet.  He was obviously telling me that he had scheduled me for a barium enema.

The day before the test I could only drink clear liquids and the night before the test I had to drink the horrible liquid that cleaned me out.  

The next morning I reported to the radiology department at the hospital.  After checking in I was taken to a dressing area where I was told to remove everything and put on the backless hospital gown.  I did that, feeling quite uncomfortable sitting there with little on to protect my modesty, even though I had tied it around my neck and waist.

Ten or fifteen minutes later a radiology tech came to the room and called my name and led me back to the x-ray room.  He had introduced himself and was very polite.  

When I entered the room I saw the fluoroscopic table and the IV pole next to it that had a large enema bag filled with the white barium solution.  Attached to the hose was an inflatable bardex nozzle that was on a mayo stand along with a stack of x-ray files, gloves, and surgilube.

He asked me what my specific symptoms were and then he explained the test to me.  After asking me if I had any questions, he told me to lie on my left side on the x-ray table with my right leg half way up to my chest.  He placed a sheet over my legs to about my knees which left the upper part of my legs exposed.  My bottom was covered by the gown.

He told me that he was going to insert the enema nozzle and then go get the radiologist and the test would begin.  I heard him put on an exam glove and then he moved my gown out of the way and I felt the cool air on my now exposed bottom.

"I'm going to lubricate you now," he said and I felt his hand on my bottom and he spread it apart to more fully expose my anus.  I felt his finger touch me and then he inserted it quickly, lubricating my sphincter.

Next he told me that he was going to insert the nozzle and again I felt my bottom being separated.  I felt the first part of the nozzle go in easily but the wide balloon part had to be forced in and it felt uncomfortable.  I remember gasping when it finally went through my anal canal.  I heard him squeezing the inflator and felt the balloon expand inside of my rectum.  It made me feel like I had to have a BM.

He left the room for several minutes, leaving me on the table with the bardex nozzle inflated inside of me.  He did cover me back up with the sheet, for which I was grateful.

What seemed like ten or fifteen minutes later, the door opened again and I heard a man come in and introduce himself as the radiologist.  He moved the fluoroscope over me on the table and then I felt the barium start to flow into my colon.  It was slightly cool.  I was asked to move onto my stomach and then onto my right side while he watched the barium flow through my colon in the fluoroscope monitor.  Periodically I heard him put in an x-ray cassette, take an x-ray, and then hand the exposed one to the radiology tech.

Finally he said he was going to drain out the barium which made me happy, but I have to say that it wasn't bad because I was so empty to start with.  But then I heard the squeeze bulb and felt myself being inflated with air.  That was uncomfortable and gave me cramps, especially as I had to move around again in different positions.

I ended up on my stomach and I felt uncovered as the sheet had become displaced with all my rolling around.  He said that the tech was going to take some more pictures and then he was gone.

The x-ray tech put a cassette next to me and then moved the x-ray tube to my left side.  I couldn't help but be aware of the enema tube and my exposed bottom.

After that picture was taken he told me that he was going to remove the nozzle, take one more picture and then I could use the bathroom.  I felt him spread my bottom apart after deflating the nozzle and pulling it from my rectum.  That was a relief!

He took another x-ray and then told me that I could get off the table, but he had to take two more x-rays after I emptied.

Gratefully I went to the adjoining bathroom and expelled the remaining barium and air.  I remember hoping that no one could hear me as I expelled the air in wet farting sounds.

He took the two post evac x-rays and then led me back to the dressing room where I was told to dress and wait until he got the all clear from the radiologist.  Fifteen or so minutes later he returned and told me that I could leave.

While everything was done very professionally, I do have to say that it was one of the more embarrassing medical procedures that I've endured.  It wasn't as bad as I had heard it would be and my results came back normal, but I hope I don't have to have another one. 


The worst part was undoubtedly the preparation. Most hospitals require a two or three day low residue diet but mine specified five days. This meant that for my examination at 3.30 pm on Thursday afternoon I had to start the diet on the previous Saturday. This is not good for morale as every white bread/white rice/chicken/fish meal without fruit or vegetables acted as a reminder of what was to come. One good piece of advice was to start building up the fluid intake whilst on the five day diet to minimize the risk of dehydration once you take the laxatives. High energy sports drinks are also useful 24-48 hours before the procedure. Do use a barrier cream before you take the first laxative and after each bowel movement and if you are lucky enough to have a bidet they are worth their weight in gold!

Despite all of the fluid intake, by mid-morning on the day of the examination I was probably getting a bit dehydrated and developed a persistent headache. On arrival at the hospital I found the receptionist frosty. After confirming my name and date of birth she told me, rather dismissively, to sit in a corridor outside the examination room. Thankfully my nurse was kind, warm and good humored. She showed me to a very small cubicle and asked me to take off all my clothes and put on the regulation hospital gown with a slit at the back. Then it was back to the busy corridor where I sat in my dressing gown.

Fortunately my husband was keeping me company; otherwise I could have felt very vulnerable. When the nurse showed me into the examination room she asked me to get on the couch and lay on my side. Rather than telling me, she asked if I knew what she was going to do and it caused come amusement when I said "Yes - you are going to put a tube up my bottom."  This was not at all painful but the downside was that I had to wait with the tube inserted and taped to my bottom for ten minutes before the doctor arrived.

The procedure was then very much as Christine has explained: lots of moving about and changing positions but throughout the nurse was very supportive, regularly telling me how well I was doing. Towards the end of the procedure the doctor said that "he couldn't see anything nasty in there" which was very reassuring. One big difference was that after all the pictures had been taken the nurse drained most of the barium through the tube so there was very little for me to pass naturally. This also meant that I didn't have to squeeze my anal muscles together when the tube was withdrawn as Christine described (I wasn't looking forward to that!) I took a windeze as soon as I reached the toilet and one later at home. I did have some stomach cramps but these were relatively mild and like the headache they passed off within an hour or two. Before we left my husband asked the radiologist why a five day diet was specified but we didn't really get a satisfactory answer. One last thing - my lovely nurse asked me if I would be having a couple of glasses of wine with dinner that evening. I certainly intended to but watch out: on such an empty stomach it doesn't take much to get quite squiffy! 


After suffering pain in my abdomen for some time (not all the time) and also passing motions which are generally really loose and sometimes liquid a few times daily for some time - having been a once a day person - my doctor tested my urine and I had blood tests which were taken after I'd fasted. I had a pelvic ultrasound too. The ultrasound showed nothing and blood tests only showed a slight raise in sugar.

1st February: I had more blood tests today and I had another ultrasound arranged to check out above the pelvic area (stomach, liver etc) on 10th February BUT I'd been booked in for a barium enema X-ray on 9th and it is this that I was concerned about. I am in Weston-Super-Mare having these tests.

I suffer from anxiety attacks especially when stressed, I couldn't think of anything else but the x-ray (and the results) and I had been having nightmares and little sleep. I have been prescribed Citalopram daily to try to stop these attacks.

7th February: I was only to eat low fiber food today. As the x-ray dept didn't tell me WHAT to eat I ate two slices of white toast with the minimal of margarine (and black coffee which I'd have anyway) for a late breakfast then three small white rolls with chicken breast and a teeny bit of mayonnaise so it wasn't so dry. I'd Googled for low fiber diets and it said I could eat chicken also mayonnaise but I really wasn't sure. I do not want to have to repeat the x-rays if I've done something wrong!

8th February: 7.30am I prepared the 1st Citramag to drink at 8am. I had to put 200ml of hot water into a large wide mouthed jug as it fizzes up LOADS! It was like adding water to Andrews Liver salts and it fizzed violently for ages as I stirred it. I shouldn't have looked into it as it had fumes coming from it that almost took my breath away. You could smell the lime and lemon, which it was flavored with, all over the house.

At 8am it was cold and looked slightly milky. I was expecting it to taste disgusting but it thankfully was very pleasant. It tasted much like a very good lemonade, the one that says "made with real lemons". I was thinking it would be great with ice cubes in the heat in July in Spain sat at a beachside cafe. I'd decided to take my laptop to the bedroom and work from there as it's next to the bathroom for convenience. It wasn't long till I felt heat starting in my stomach then I needed to go. I've not had solid motions in ages and I'm used to having diarrhea, that's one reason I'm being investigated. A while later the fire began in earnest, another trip to the bathroom.

I could have white bread and a boiled or poached egg for breakfast with the same for lunch (plus cheese and clear soup like minestrone with the 'bits' strained out) and I had to fit lunch in before 4pm which was the latest time I was meant to take the 2nd dose of Citramag laxative. So, I made some toast at around 11am and was waiting for it to cool when the need took over and I flew upstairs to the bathroom. OMG! I had such incredible pain in my stomach and felt sick too. I shouted out in pain and yelled "fetch a bucket fast" to my husband who, thankfully, was within hearing distance. Jeez!!! When your stomach is empty you bring up what tastes like grapefruit juice, awful. When the intense pain hit I vomited and crapped together, I was sweating and yet I felt chilled too. I felt desperate. Suddenly the sickness left me as fast as it had comeand I managed to eat my toast. I was given a reprieve from going to the bathroom and I could rest on my bed (which is by the bathroom ... just in case!)

I had more toast with a few teaspoonfuls of plain cottage cheese around 3pm - I couldn't face egg - then made up the 2nd Citramag and thought "I'm not looking forward to this, AT ALL!" At 4pm I drank that and waited and waited and waited! It was ages till my stomach stirred, it rumbled rather than felt it was on fire. I never felt any urge (or pain) to go to the bathroom with this 2nd lot, I had to remind myself to go and, by then, it was like shitting through the eye of a needle.

By 7pm I decided my bowels had settled down enough to venture downstairs to watch TV in the lounge with my husband. I kept popping to the bathroom and more came away. At bedtime I'd felt I'd got off lightly with this 2nd dose. When I lay down I felt I had to go and that happened twice before I could settle. I woke a few times during the night to go then too so I didn't have a restful night. I was also feeling shaky about this test and, quite naturally, the results.

9th February: I went to the bathroom a few more times before leaving home 9.45am, feeling washed out by then, and was dismayed to see I was still passing bits of feces in water and I had the worst feeling it was going to affect the X-rays. I can't do this again, I had heard it's the preparation that's the worse part.

My appt was at Weston Super Mare's General hospital which is the other side of town to us. I'd not even sat down when I was called through into a private changing room right by the waiting room.

A really sweet young nurse called Cheryl of around 25 said she was going to look after me. She said Steve was the consultant radiologist who was going to do the x-rays but she would be with me at all times. She saw I was very nervous .. crying and shaking in fact with fright .. but was very reassuring and said it would take 10 minutes if that and they'd stop if I wanted them to. She explained what Steve was going to do. I asked if nothing was found could they please let me know rather than me have to worry up to two weeks for my doctor to get the results especially as I'm meant to be flying to Spain for two months on March 3rd. Cheryl said Steve would certainly do that. I was given two cotton gowns, one to wear with the ties at the back, the other to wear like a dressing gown to preserve my modesty. Cheryl called me into a dimmed X-ray room where I met Steve - looked maybe mid 30's - who also was very personable. He explained the procedure in greater detail and Cheryl had obviously had told him I was very nervous.

I sat on the edge of a narrow padded X-ray table and then lay down with my head on a pillow, my feet against a metal footrest. Steve explained he would give me an injection of Buscopan into a vein to relax my bowel which makes it more comfortable for me and easier for him to get clearer images. He couldn't find my vein in my right elbow but my left one was fine and I felt nothing, needles don't bother me anyway. Then he asked me to roll onto my left side so he could insert a tube into my anus. He put gel on my anus and very slowly inserted the tube which I didn't see but I think it was probably 1/2" in diameter, Steve said it only goes in about 2". I think his 2" differs to my 2" though. It seemed to be in further than that, it wasn't very pleasant but it was over in seconds. He said he was going to tape the tube to my bottom so it didn't come out as I'd be asked to move positions a lot. Then he said barium was flowing into my colon, I felt nothing at all till he added a bit of air when I felt like I wanted to go to the WC but the air was added very slowly. It didn't phase me and I didn't get cramps like I've read many others experience. The air expands the colon so the barium coats the colon easily. He added more air as the barium moved further into my colon.

I started off on my left side then moved onto my back then onto my right side then I was tilted so I was almost standing up then flat on my back again then into a position where my head was lower than my legs. I also was asked to position myself partway between flat and each side, that was awkward as the x-ray machine was just above me so not much room. Cheryl was constantly keeping me reassured. (I was worried I'd fall off the narrow table). Steve asked me if I'd like to watch on the monitor and I watched with great interest. He explained that, if I watched a narrow part of the colon he was pointing out, it would expand as he puffed more air in. Fascinating. He said he'd done around 6,000 barium enema X-rays.

It was over fast (10 minutes Cheryl had said) and certainly not painful or with much discomfort. I'd worried about having the procedure since my Dr had said she was ordering one over two weeks ago. I'd suffered nightmares and anxiety attacks over it too, mainly the results should it indicate cancer, everyone's concern. The barium bag was taken down and laid on the floor allowing the 300ml of barium (Steve said only 300ml was required to check 4 ft of colon) back into

the bag. This, I was told, meant I wouldn't have the cramping as bad. I was shown to the WC where I was told to take as long as I liked to make myself comfortable and I was ok within a minute. I was expecting to feel bad and I didn't.

Steve assured me he had seen nothing of concern, no cancers and no polyps either though he explained he wouldn't see any polyps under 5mm. That was the news I wanted, the news I'd dared to hope for.

I said I had to return tomorrow to have an ultrasound of my stomach area having already had one of my pelvic area. I said I'd rung to ask if I could maybe have the ultrasound straight after the barium enema but was told the barium would affect the results but I could have the ultrasound the following day as already planned. Steve said the barium can stay in your system for a week so if I couldn't have the ultrasound that day I should not be having it tomorrow anyway (I said I'd rung Saturday and left a message and x-ray rang me Monday with wrong info then, he said they're only clerks!! I said they should give CORRECT info when patients ask otherwise what's the point?? This is the 2nd time I've been given incorrect info by the x-ray dept) Steve said it would be ok to have it today and he'd try to find someone free to do it whilst I went to the WC and got dressed. Within 5 minutes he notified me that a consultant was free so he would do it and within 15 minutes I'd had the ultrasound and then drunk the coffee that Cheryl had made me too..

I took two Windsetlers gel caps (someone posting on here suggested taking Wind-Eze as soon after the test as possible to stop any cramping, I bought Windsetlers, same thing but almost half the price from Boots Chemists) once in the car and felt well enough, no wind, to go shopping in Aldi on the way home.

Although most of the barium was drained out of me I was told to ensure I ate high fiber foods like granary bread, Fruit 'n Fiber cereal, baked beans etc which would stop constipation which could likely occur otherwise. I was told my feces would be white for up to 36 hours too. What they didn't say was the barium was like sludgy clay and could well be a problem flushing it away.

10th; We thought we'd get round that by keeping a large bucket in the bathroom and chucking water from that into the WC. After Googling I was worried the barium would clog up the WC out of sight, warranting an expensive visit from a plumber, so when it wouldn't flush away I donned a pair of Marigolds and gently put my hand down the pan and carefully managed to retrieve the barium Subsequent 'dumps' flushed away without problems, getting back to normality fast.

All in all I would never be concerned again about the test but the Citramag, whilst I found very pleasant to drink, caused me pain and sickness with the initial dose.

It obviously helped that Cheryl and Steve were very caring and reassuring, THAT made such a difference as did what I had read on here, thanks!


I had my barium enema last week at the Great Western in Swindon. After reading other websites I was apprehensive and nearly cancelled, but this site lessened my nerves. There was nothing to worry about at all, but there was some good advice from other posts that I followed and I think that helped.

The 2 days of a bland diet was no problem for me, as I'm not a big fruit & veg fan to start with. Day 3 was laxative time; two sachets of Citramag. I took the advice of one poster and took the first one over the space of an hour, this seemed to make it a little less violent than others have reported. The second I took over half an hour. I was going to the toilet every hour or so, and never so urgently that I didn't make it on time. No solid food all day, but apart from my boyfriend teasing me with food that evening, the fasting wasn't too bad.

I'd bought some Sudocrem to apply if my bottom got sore, and on the first sign that it was I started applying the cream after each bowel movement. No sore bottom, I think it also helped with the enema as well.

Day 4 was the day of my enema, my appointment wasn't until late afternoon, and no food or drink (although you are allowed a sandwich no earlier than an hour before the procedure, I didn't fancy it).

At the hospital I was shown into a cubicle to change into a gown. The nurse asked a few questions and gave me some information. Then I was shown into the X-Ray room. I was asked to lay on my side while she inserted the tube. It didn't hurt, and if she inflated a balloon to hold it in I certainly couldn't feel it. Another nurse gave me an injection of muscle relaxant in my hand and apart from the usual sting it was nothing. Then they pumped in barium and air. There was no cramping, I just felt a little bloated, but certainly no worse than when I've had trapped wind.

I was asked to move into various positions (and this was only uncomfortable due to a slipped disc). Once they'd taken all the X-Rays I was asked to give a few hard coughs to expel the barium & air back down the tube. She then removed the tube. I felt fine and was free to go; all in all about 25 minutes. I took a couple of Windeze straight afterwards. I felt like I had trapped wind, but it was only mildly uncomfortable. At home I went to the toilet a couple of times, but only wind until a bit later when I started eating & drinking. The barium formed lumps an refused to flush away.

After being a bit windy, normal service was resumed the next day. No pain, no constipation.

I know some people have had worse experiences, but this was mine, and it was a breeze - don't let any horror stories put you off, because you never know it could be as painless a procedure for you as it was for me. I'm still waiting for my results, but if they find anything wrong, or even if they don't, it was worthwhile either way.

Students demonstrate the barium enema procedure.

Click to watch

I read the other experiences before leaving for my own this afternoon, and promised the radiographer that I would post this. She was lovely, understanding and helpful throughout and made sure I understood exactly what was going on and what I needed to do to make sure it was a satisfactory x ray.

I am one of the most nervous of patients imaginable! I had already had a colonography about two years ago - and found that to be not anything like as bad an experience as my brother in law had led me to believe. Nothing at all like his experience!

This one was the same. No problem! The very worst part was the journey home in the car when I really needed to pass wind, but I was afraid to do so in case I made a mess!! By the end of the journey, I am afraid that the relief of passing it outweighed the fear of the mess. I would suggest that anyone undergoing this would best choose to stay around the hospital and near the toilets for about an hour after the procedure. I wish I had done so in retrospect. Still, there was no big deal regarding the mess - just barium coming out because the picolax had done its best!!

If you are due to have this procedure done then please do not worry about it at all - the procedure itself is the very least of the problem regarding the whole thing. The picolax for me was the worst, followed by the above problem on the way home! NONE of it a big deal - after all my worry!!

I did listen to the advice given by others regarding the 'Windeze' - and feel fairly sure that it helped. I took it as soon as I came out of the x ray room. It cost 3.99 in Lloyd's chemist, but was definitely worth it.

I am now turning my mind to the result. Hopefully, it will be a good one! Anyway, I am hoping to go to Madeira on holiday over the Christmas - and thinking of that should take my mind off the other.

 

A barium enema on a fluoroscope screen.

I arrived at the radiology department of my local hospital at 9:30AM. I was asked to come back by a girl working in the exam room. She showed me a paper gown and told me to undress completely and put my clothes and watch in a provided plastic bag. She told me to come out of the changing room after I put the gown on, and turn left to the next door that led to the exam room. The room was dimly lit and had pink colored tile with the usual stainless steel table and x-ray machine. There were two female technologists, one young and one middle-aged. I was asked to lie on the x-ray table for a series of "scout shots". The second shot showed signs that the laxative bowel prep was unsuccessful. The older tech asked me if I wanted to skip the test for a day and redo the laxative prep, or be given a cleansing enema right then so the test could go as planned. I hated the taste of the laxative, and just one more enema couldn't be all that bad, so I chose the enema.

They took me back to the changing room to wait about 20 minutes, then came back and took me to an adjacent room with a toilet and exam table. A large clear bag filled full with milky solution was hanging on an IV stand. It had clear tubing and the final 7" or 8" of the tube was larger diameter (penny width) translucent blue with two holes at the end. After about 5 minutes, a 35ish or 40ish female CNA came in and told me she was going to give me a full saline enema bowel prep to flush out remaining stool that was still in my ascending colon. She had me get on my left side and bend my right knee to my chest, and had me put my left arm behind my back. She lubricated the enema tip with K-Y, and then proceeded to raise my right buttock. With my buttocks spread, she asked me to take a deep breath...the tip was placed at my anus... then exhale, as she swiftly slid the tip up into my rectum 4"-5" with one well guided push. The insertion didn't hurt, but did feel uncomfortably invasive because I hadn't had anything inserted rectally since I was a child. The nurse promptly opened the clamp, and I was greeted with a sudden gush of very warm saline that actually felt a little too hot for comfort. I cramped at about half a bag, so she stopped several times till most of it was in. She helped me off the table and to the commode. Standing with my back to the commode, she had me bend over a little, and with one audible slurp she removed the tip from my rectum. I quickly sat on the commode and exploded out the saline.

The scout x-rays that followed passed with flying colors and the barium enema was prepared. I was helped onto the ice cold x-ray table by the young technologist. She told me to bring both knees toward my chest. I saw her lubricate a light blue barium tip, and asked her if it was going to hurt. She said it wasn't as bad as it looked, just mildly uncomfortable for a few seconds. Just as the nurse before, she raised my butt cheek and told me to breathe in and then exhale. This time I felt a pressure and a little discomfort that faded as the nozzle passed my sphincter, and was inserted fully up my rectum. Next she inflated the tip, and I gasped in surprise. It felt like a sensation to break wind just inside my butthole. She opened the clamp and in came a torrent of cool feeling barium. I held almost 3/4 of the bag till 9 x-rays were taken, and the tech had me get off the table and bend forward. She deflated the tip, slowly removed it, and I raced to expel in the nearby commode. Back on the table again, the nozzle was reinserted, a little more uncomfortable this time because my anus was getting sore. Tip reinflated, then the tech tells me she's going to put air into my colon to get double contrast x-rays. I started cramping suddenly, like mild gas pains. Then the cramping got worse...a few x-rays taken...I had to turn onto my right side. By now the cramps were getting unbearable...the last 3 x-rays taken. She opened the valve and I felt immediate relief. She removed the nozzle from my rectum and helped me off the table. I went back to the commode to expel residual barium and the remaining air. I got dressed, and the tech said the test went well. She gave me a bag with a couple fleet enemas to take back home. She told me to take those about 4 hours apart to get any residual barium out. My wife recommended that I go have a colonic to make sure all of it was out. I managed to get an appointment with her therapist the next day, of which that experience was a piece of cake compared to the barium enema. The barium test itself concluded that hard stool had scraped the upper portion of my rectum, causing bleeding. I'm bothered by occasional constipation anyway, so the results were a relief since it wasn't anything serious. I don't want to have to go through with a barium enema ever again. I have colonics often to help keep my bowels in check.



 
   

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