Lower GI Series (Barium Enema)
What is a lower GI series?
A lower GI series uses x-rays to help find problems of the large intestine, which includes the colon and rectum. A lower GI series is sometimes called a barium enema because the large intestine is filled with barium liquid.
A lower GI series can be used to help find the cause of
- Chronic diarrhea.
- Bleeding from the rectum.
- Abdominal (belly) pain.
- Changes in bowel habits.
- Unexplained weight loss.
A lower GI series is done by a radiology technologist or a radiologist (a doctor who specializes in x-ray imaging) at a hospital or outpatient center.
How do I prepare for a lower GI series?
You should tell your doctor about any health problems before having this test done. This includes allergies to medications and/or foods and all medications you are taking. If you have kidney disease, you may need to follow special preparation instructions.
Women should let their doctor know if they might be pregnant. Special precautions can be taken to lessen radiation exposure to the baby.
In order to prepare for a lower GI series, you must get rid of all of the solids in the intestines. You will be given specific instructions to follow, as these can differ from one center to another.
Often, these instructions call for a clear liquid diet for 1 to 3 days prior to the exam. A clear liquid diet means that you can have liquids (broth, ginger ale, tea, Gatorade) and some foods (jello) that are “clear” or you can see through. Do not eat or drink anything that is red, blue, or purple.
In addition, you may need to take a laxative or enema the night before the exam. Instructions will be given on which to use.
If only the rectum or end of the colon is being tested, emptying all solids from the entire GI tract is not necessary. Instead, you will be given one or more enemas the day of the procedure to remove solids from just the large intestine.
How is this test done?
You will lie on an x-ray table. A lubricated tube is inserted into the anus. Barium liquid is put through the tube into the large intestine. Leakage of barium liquid is prevented by an inflated balloon on the end of the tube. You may feel some discomfort and will feel the urge to have a bowel movement.
X-ray pictures and sometimes video is taken while you hold still in different positions. You may be asked to hold your breath at some points during the test. If a technologist is doing the lower GI series, a radiologist will later look at the images.
When the imaging is complete, the balloon on the tube is deflated. Most of the barium liquid drains back through the tube. You will then get rid of the remaining barium liquid into a bedpan or nearby toilet. An enema may be used to flush out the rest of the barium liquid.
The entire procedure takes 30 to 60 minutes.
What can I expect after a lower GI series?
For an hour or so after the procedure, most patients experience bloating and cramping in the abdomen (belly). Repeated bowel movements and enemas during the bowel prep may cause the anus to be sore. For several days, barium liquid in the large intestine will cause stools to be white or light-colored.
Unless otherwise directed, you may resume your normal diet.
Mild constipation from the barium liquid is the most common side effect. To avoid this, drink plenty of fluid after the exam.
How do I receive the results of my lower GI series?
You may receive some results of your test the day it is done. The official results and report of this test are usually available in 7-10 days. Your care provider will be able to discuss these results with you.
When should I call my care team?
In rare cases, barium can block the intestines. This can be a serious, life-threatening condition. Symptoms of this are:
- Severe abdominal (belly) pain.
- Being unable to have a bowel movement within 2 days after the procedure.
- Being unable to pass gas.
- Bleeding from the rectum.
Barium can also cause an allergic reaction in some people. Signs of an allergic reaction include hives, itching, difficulty breathing, agitation, or confusion.
Call your care team if you have any of these rare side effects. If you are unable to contact your care team, call 911 or visit an emergency room.
National Institute of Diabetes and Digestive and Kidney Diseases. Lower GI Series. 2016. Found at: https://www.niddk.nih.gov/health-information/diagnostic-tests/lower-gi-series
RadiologyInfo.org. X-Ray (radiography) - Lower GI Tract. 2017. Found at: https://www.radiologyinfo.org/en/info.cfm?pg=lowergi#results