Lower GI Series (Barium Enema)

A lower GI series is a test that uses X-rays to look at your large intestine, which includes your colon and rectum. A lower GI series may be called a barium enema because the large intestine is filled with a chalky liquid called barium.

When is a lower GI series done?

A lower GI series can be used to help find the cause of:

• Diarrhea that does not go away.
• 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 specializing in X-ray imaging) at a hospital or outpatient center.

How do I get ready for a lower GI series?

Before you have a lower GI series, you must get rid of all solids in your intestines. You will be given instructions to follow, which can differ from one center to another.

Your instructions may include a clear liquid diet for 1 to 3 days before 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 that you can see through. Do not eat or drink anything with red, blue, or purple coloring.

You may also need to take a laxative or enema the night before the test. Instructions will be given on which to use.

If only your rectum or the end of your colon is being tested, you may not need to empty all solids from your whole GI tract. Instead, you will be given one or more enemas on the day of the test to remove solids from the large intestine.

Tell your healthcare provider about any health issues before this test. This includes allergies to medications and/or foods and all medications you are taking. If you have kidney disease, you may be given different instructions based on your needs. You should let your care team know if you are or may be pregnant. Special precautions can be taken to lessen radiation exposure to the baby.

How is this test done?

For this test, you will lie on an X-ray table. A lubricated tube is placed into your anus. Barium liquid is put through the tube into your large intestine. Any leakage of barium liquid is stopped by an inflated (pumped up) balloon on the end of the tube. You may feel some pain and will likely 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 look at the images after the test is done.

When the imaging is done, the balloon on the tube is deflated (air is let out). Most of the barium liquid drains back through the tube. You will then get rid of the rest of the barium liquid in a bedpan or nearby toilet. An enema may also be used to flush out the rest of the barium liquid. The whole test takes 30 to 60 minutes.

What can I expect after a lower GI series?

For an hour or so after the test, you may have bloating and cramping in the abdomen (belly). Repeated bowel movements and enemas during the bowel prep may cause your anus to be sore. For a few days, barium liquid in the large intestine will cause your stools to be white or light-colored.

Unless your healthcare provider tells you not to, you can often go back to 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 get the results of my lower GI series?

You may get some test results on the same day. The official results and report of the test are often available in 7 to 10 days. Your healthcare provider will talk with you about these results.

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 test.
• Being unable to pass gas.
• Fever.
• Bleeding from the rectum.

Barium can also cause an allergic reaction. Signs of an allergic reaction include hives, itching, having a hard time breathing, agitation, or confusion.

Call your care team if you have any of these rare side effects. If you are unable to call your care team, call 911 or visit an emergency room.