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X-Ray Lower GI Tract

Lower gastrointestinal (GI) tract radiography, also called a lower GI or barium enema, is an X-ray examination of the large intestine, also known as the colon. This includes the right or ascending colon, the transverse colon, the left or descending colon, sigmoid colon and the rectum. The appendix and a portion of the distal small intestine may also be included.

An X-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. The lower GI uses a special form of X-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast. Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.

Your doctor may recommend a lower GI examination to detect benign tumors (such as polyps), cancer, or causes of other intestinal illnesses. The procedure is frequently performed to help diagnose symptoms such as:

  • Chronic diarrhea
  • Blood in stools
  • Constipation
  • Irritable bowel syndrome
  • Unexplained weight loss
  • A change in bowel habits
  • Suspected blood loss
  • Abdominal pain

Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.

The lower GI exam is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time. A radiology technologist and a radiologist guide the patient through the barium enema. The patient is positioned on the examination table and an X-ray film is taken to ensure the bowel is clean. After performing a rectal examination, the radiologist or technologist will then insert a small tube into the rectum and begin to instill, using gravity, a mixture of barium and water into the colon. Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon.

Next, a series of X-ray images are taken. The patient may be repositioned frequently in order to image the colon from several angles. When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. Once the X-ray images are completed, most of the barium will be emptied through the tube. The patient will then expel the remaining barium and air in the restroom. In some cases, additional X-ray images will be taken. A barium enema is usually completed within 30 to 60 minutes.

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Low dose radiation produces internal images.

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