What is a barium CT scan? How does it work? Who should have this procedure? Get answers to these questions and more.

What is a Barium CT Scan?

A barium CT scan, also known as a barium enema, is a type of lower gastrointestinal (GI) tract radiography procedure. It uses fluoroscopy, a real-time X-ray technology, to get a closer look at the large intestine and detect any abnormalities or pinpoint the cause of chronic constipation, blood in the stool, or abdominal pain.

How Does a Barium CT Scan Work?

During the procedure, a technologist uses a continuous or pulsed X-ray beam and fluoroscopy to examine the right and left colon, sigmoid colon, rectum, appendix, and distal small intestine (if requested). Fluoroscopy generates a series of images onto a monitor, allowing a radiologist to evaluate the movement and function of internal organs. Contrast material, such as barium or iodine, is used to make the examined areas more identifiable and defined.

The patient is positioned on a table, and an image is taken to ensure the bowels are emptied. A rectal exam is then performed, and a small tube is inserted into the area. Through gravity, the tube allows a mixture of water and barium to spread and coat the lining of the colon, helping to keep the solution contained within the colon. The technologist then takes a series of X-rays, during which the patient is asked to stay still and briefly hold their breath to avoid blurriness. To capture the colon from multiple angles, the patient may be repositioned throughout the procedure.

Who Should Have a Barium CT Scan?

Doctors typically recommend a barium enema if a patient shows any signs of the following conditions:

• Cancer
• Polyps
• Ulcerative colitis
• Intestinal blockage
• Crohn’s disease
• Inflammatory bowel disease
• Chronic diarrhea
• Ongoing constipation
• Blood in stool or suspected blood loss
• Unexplained weight loss
• Distinctive change in bowel habits

Patients should inform their doctor if they are pregnant, as the fluoroscopy may expose the fetus to radiation, and if they have any allergies, particularly to barium and similar contrast materials, or any medical conditions or recent illnesses.

What Can Patients Expect During a Barium CT Scan?

Similar to a colonoscopy, there are prior steps to prepare for a barium enema. Generally, this involves cleansing the bowel through the use of a liquid or pill laxative or an over-the-counter enema, restricting foods and liquids the day before, not eating or drinking after midnight on the day of the procedure, and taking prescribed medications with sips of water.

The barium enema is an outpatient procedure that can take anywhere from 30 to 60 minutes. Patients are advised to wear loose, comfortable clothing and remove any jewelry, eyeglasses, dental devices, or other metal objects. Once the examination is complete, the doctor may offer a laxative or enema to assist with removing the barium dye from the system, and the patient can immediately resume their standard diet and medications.

What is an Abdominal CT Scan with Contrast?

An abdominal CT scan with contrast is a type of specialized X-ray that can show the organs, blood vessels, and bones in the abdominal cavity. The multiple images provided give the doctor many different views of the body. The CT scan machine circles the body and sends the images to a computer, where they are viewed by a technician.

Why Would a Doctor Order an Abdominal CT Scan?

Abdominal CT scans are used when a doctor suspects something might be wrong in the abdominal area but can’t find enough information through a physical exam or lab tests. Some of the reasons a doctor may order an abdominal CT scan include:

• Abdominal pain
• A mass in the abdomen that can be felt
• Kidney stones (to check for size and location)
• Unexplained weight loss
• Infections, such as appendicitis
• To check for intestinal obstruction
• Inflammation of the intestines, such as Crohn’s disease
• Injuries following trauma
• A recent cancer diagnosis

Doctors may choose a CT scan over an MRI because it is faster and more comfortable for patients who are uncomfortable in small spaces.