Barium examinations

• The Barium X-Ray Machine
• Important safety information
• Preparation
• On arrival
• The examination
• After the examination
• A patient's perspective

The Barium X-Ray Machine

• The barium x-ray machine is a table which can tilt, with an arm coming across which delivers or detects the x-rays. Within the room there will usually be either a radiologist and a radiographer or just a radiographer and sometimes a nurse.
• The barium examinations use x-rays to obtain the pictures. In this room many different investigations involving contrast (dye) or barium are performed. Most commonly, they will be the barium enema, looking at the colon, the barium swallow or meal, looking at your oesophagus (gullet) and stomach or the barium follow-through or small bowel meal, looking at the small bowel. The barium is high density but not radioactive and is detected by the x-rays.
• This kind of investigation has been used for many, many years and was started just after the start of diagnostic x-rays at the turn of the last century. Often it provides information about the function of the gut and can demonstrate pathologies, which sometimes need other investigations.
• Usually the different tests will take between 15 minutes and one hour. Sometimes, with the investigation of the small bowel, this can take longer.

Important safety information

• For women of child bearing age - If there is any chance that you might be pregnant or are trying for a family, please contact Clinical Radiology so the best date can be arranged for your appointment.
• Medications should be continued as prescribed unless told otherwise by your doctor. (See specific appointment letter for your examination).
• If you are diabetic please bring your insulin with you when you attend for your appointment.
• Patients on dialysis please refer to your appointment letter for specific instructions.

Preparation

There are various different preparations for each type of Barium Examination as well as for different ages and types of patients. Most Bariums examinations require fasting for a period. A Barium Enema also requires the taking of a strong laxative to clear out the bowl prior to the examination. (Please refer to your appointment letter for specific details).

On arrival

• Please report to the X-Ray Outpatient Reception at your appointment time.

The examination

There are various different Barium Examinations, please find an explanation of some of the more common ones below. For all other types of Barium Exams, please refer to your appointment letter.

Barium Enema

A small plastic tube is inserted into the back passage and a small amount of barium is allowed to flow through this tube to coat the surface of the bowel. The doctor will watch this on the monitor and take x-rays in several different positions. Air is used as well as barium to help to visualise the bowel, and patients can experience slight abdominal cramps from this. A small injection may be given to relieve this, which can make your vision slightly blurred. If this injection is required you should refrain from driving for an hour after receiving it to allow your vision to return to normal. At the end of the examination you will be shown to the nearest toilet to pass the barium.

Barium Meal or Swallow

You will be given some fizzy powder to take with lemon juice. This produces air in the stomach, which allows the stomach to be seen clearly. You will then be given some barium liquid to drink. X-rays will be taken in different positions while you are drinking, with you standing and with you lying flat.

Once the doctor (radiologist) has checked that there are sufficient x-rays, you will be able to leave the department. It is sometimes necessary to give a small injection during a barium meal. This relaxes the muscles in the stomach and allows better images to be taken. The injection may cause blurred vision, so it is important you do not drive for an hour after receiving it, to allow your vision to return to normal. If you have any questions, please do not hesitate to ask.

After the examination

• You are able to go to the toilet and get rid of the Barium in the case of a Barium Enema.
• You will be allowed to get dressed and if you are feeling well you will be able to leave the department.
• A written result will be sent in 7 to 10 days to the Doctor who has referred you for your Barium.

A patient's perspective

I had been sent a leaflet explaining what I had to do and what would happen. This principally concerned my taking a strong laxative, Picolax, on the day before. The laxative was so effective there would have been very little chance of going out during the 30 hours prior to the examination.

On arrival in the radiology department, I was asked to undress and put on a surgical gown and dressing gown. My clothes were put in a basket and I had to carry them into the examination room. I laid on the x-ray couch and momentarily lying on my side the radiographer inserted a small tube into my rectum through which the barium fluid could be inserted into my bowel.

A radiologist remained in the room throughout operating the x-ray equipment and looking at the image on a TV monitor. Several times the radiologist pumped a further small quantity of fluid into my rectum, enabling additional images to be displayed after each stage. I asked if I could see these images and the radiologist kindly obliged by suitable positioning of the monitor. After some time I was advised that some air would be blown additionally into my bowel, so making it feel slightly bloated. I was asked to lie on my sides in turn to enable further images to be taken.

Towards the end of the examination, while lying on my back, the couch was tilted at steep angles with first my head being very low followed about a minute later with my head being raised. All the while additional images were being taken. I was warned in advance that this makes some people temporarily a little dizzy. Indeed I did feel dizzy for a few seconds.

On completion I visited the toilet and got dressed. I asked the radiologist if he had seen anything of concern, and he said the images would have to be studied later when a report would be prepared and sent to the referring consultant within the next 10 days. However, he said he hadn't noticed anything to worry about so far, but he couldn't be sure.

The whole time spent in department lasted about three quarters of an hour. The laxative was powerful and I had to be near a toilet for the 30 hours prior to the examination. As for the examination itself, apart from feeling dizzy momentarily, I felt only a slight discomfort in my bowel and after a cup of tea was back to normal and drove home.