| A lower gastrointestinal series, also called a barium enema, is an imaging procedure that allows visualization of the large intestine.
In a single-contrast barium enema, the large intestine is emptied of stool by fasting and laxative use. Next, barium, a radiopaque contrast medium, is instilled into the large intestine (colon) by way of the rectum. The barium makes the general outline of the colon visible on x-ray film. A more detailed examination of the colon can be done if air is introduced after the barium is expelled. This procedure is called an air-contrast or double-contrast barium enema. Either type of lower GI series is typically done as an outpatient procedure. Lower GI series are used as a diagnostic tool for a number of conditions, a screening tool for colorectal cancer; and also occasionally used therapeutically to reduce a sigmoid volvulus. |
Source: Medical Disability Advisor
| A lower gastrointestinal series is done to visualize the large intestine. The procedure may be done in response to a change in the pattern of bowel movements, unexplained lower abdominal pain, or blood in the stool. By allowing visualization of abnormalities on x-ray or by fluoroscopy, a lower gastrointestinal series can help diagnose colon cancer; polyps, diverticulitis, Crohn's disease, ulcerative colitis, granulomatous colitis, and other inflammatory bowel diseases; structural changes in the intestine such as telescoping of the bowel (intussusception), sigmoid volvulus, and torsion; gastroenteritis; irritable bowel disease; vascular injury due to vessel (arterial) occlusion; and certain cases of appendicitis. |
Source: Medical Disability Advisor
| Either type of lower GI series is normally done as an outpatient procedure in a physician's office or hospital radiology department. Before the procedure can begin, the bowel must be cleared of all feces. This is done by restricting the individual's diet for 24 to 48 hours before the test and through the use of laxatives. Warm water enemas may also be used to cleanse the bowel.
The individual lies on his or her side while a well-lubricated enema tube is inserted gently into the rectum. Radiopaque contrast medium (barium) is then instilled into the colon, and a balloon at the tip of the enema tube may be inflated to help keep the barium inside. This may cause a feeling of fullness and mild discomfort. The flow of barium into the colon is monitored in real time on a screen using a fluoroscope, so that the procedure can be stopped if complications occur.
Lower GI series often take 1 to 2 hours. During the procedure, the individual will be asked to move to different positions, and the table may be tipped slightly to allow the entire bowel to be visualized. When x-rays are being taken, the individual may be asked to hold his or her breath to ensure clear pictures.
After the pictures have been taken and the individual has been given a chance to evacuate the barium from the bowel, additional x-rays may be taken. If a double-contrast (also called an air-contrast) examination is being done, the enema tube will be reinserted and a small amount of air gently introduced into the colon. More x-ray pictures are then taken. Air-contrast examinations give a more detailed picture of the mucosal surface of the bowel. When the procedure is complete, the enema tube is removed. |
Source: Medical Disability Advisor
| During single-contrast barium enema, the colon will be filled with barium, and the shape of the colon will be clearly apparent. During double-contrast barium enema, the colon will be uniformly distended with air, and a thin layer of barium will provide excellent visualization of the details of the inner lining (mucosa). The individual should experience no disability from the procedure, but it is normal for the individual to continue to expel some barium in the next one or two bowel movements following the procedure. |
Source: Medical Disability Advisor
| Complications that might result from lower gastrointestinal series include constipation or diarrhea, bloating, cramping, nausea or vomiting, lower abdominal pain, tightness in the chest or troubled breathing, or wheezing. Perforation of the bowel occurs in 1 of every 25,000 procedures (Grainger 1102). Women who are or may be pregnant should inform the radiologist so that exposure of the fetus to x-rays can be minimized. |
Source: Medical Disability Advisor
| Work restrictions are normally unnecessary after this procedure. The individual may require ready access to bathroom facilities for 24 hours following the procedure. |
Source: Medical Disability Advisor
| Grainger, Ronald G. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. Philadelphia: W.B. Saunders, 2001. |
Source: Medical Disability Advisor