A barium enema in a disposable bag manufactured for that purpose Barium enema can be done in two ways, namely double contrast and single contrast methods. Double contrast (where air is inflated into the bowel after excess barium are drained through anus) is useful in visualisng mucosal pattern. For single contrast study (whole bowel is filled up with barium without inflating any air), it is used to visualise any obstruction in the large bowel, and it is used in children where visualisation of mucosal pattern is not needed. Barium enema is also used to reduce an intussusception where this disorder is more commonly found in children. 500 ml of Polibar 150% (barium sulfate suspension) is used to perform this study. Subject should be fasted and Picolax (sodium picosulfate) is taken orally to empty the bowels before barium enema procedure. This test may be done in a hospital or clinic. The individual lies on the X-ray table and a preliminary X-ray is taken. The individual is then asked to lie on their side while a well lubricated enema tube is inserted into the rectum. As the enema enters the body, the individual might have the sensation that they need to have a bowel movement. The barium sulfate, a radiodense (shows as white on X-ray) contrast medium, flows through the rectum into the colon. A large balloon at the tip of the enema tube may be inflated to help keep the barium sulfate inside. The flow of the barium sulfate is monitored by the health care provider on an X-ray fluoroscope screen (like a TV monitor). Air may be puffed into the colon to distend it and provide better images (often called a "double-contrast" exam). If air is used, the enema tube will be reinserted if it had been removed and a small amount of air will be introduced into the colon, and more X-ray pictures are taken. The individual is usually asked to move to different positions and the table is slightly tipped to get different views. If there is a suspected bowel perforation, a water-soluble contrast agent (such as diatrizoate) is used instead of barium. The procedure is otherwise very similar, although the images will be of poorer quality. If a perforation exists, the contrast will leak from the bowel to the peritoneal cavity; water-soluble material is less obscuring compared to barium should an abdominal incision to remove the contrast be necessary. Radiographic views Assume that the x-ray tube is moving above the table and the x-ray film is moving below the table (overcouch): The subject lying supine to give AP (anteroposterior) view of all the bowels. Left lateral view of rectum is to view the rectum from lateral position. Right anterior oblique (RAO) position is to view the caecum, ascending colon, right hepatic flexure and sigmoid colon without overlapping of other bowels. Left anterior oblique (LAO) position is to view the splenic flexure without overlapping of other bowels. Left posterior oblique (LPO) position is to view the sigmoid colon without overlapping of other bowels. Hampton's view (prone caudal view) is taken when the subject is in prone position with the X-ray tube tilted towards the feet at 30 degrees. This is to separate out the loops of sigmoid colon. Other views include right and left decubitus views
Lower gastrointestinal series
Upper gastrointestinal series
GI cocktail
Defecography
Computed tomography enterography
Capsule endoscopy
Enteroscopy
EGS 