Double-Contrast Barium Enema

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Can find cancer in earliest stage, when most treatable

Varies

Slight risk of perforation

Every 5-10 years

Cheaper option to colonoscopy

Advantages

Done without sedation
Very low risk
Less expensive than a colonoscopy
Identifies lesions in the entire colon
Accurate for finding abnormalities, such as narrowed areas or pockets or sacs in the intestinal wall

Disadvantages

Polyps cannot be removed during the procedure — you will need to get a colonoscopy if abnormalities are spotted on x-rays
Requires laxative preparation
Some may find the test uncomfortable or embarrassing
Availability is decreasing; usually only for those who cannot undergo colonoscopy
Uses x-ray radiation

What can I expect for a bill?

Average cost before insurance: $250 - $500

Will my insurance cover it?

Many plans cover it, so check with your policy holder. Medicare varies, as sometimes this procedure may be substituted for a colonoscopy. Check with Medicare.

The Double-Contrast Barium Enema (also called DCBE or barium enema) procedure uses x-rays to find abnormalities such as polyps or cancer. Barium, a silver-white metallic compound, is used to outline the colon and rectum on the x-ray. Air is then passed through the same tube to further enhance the x-ray.

Why chose to have a barium enema? Barium enemas are low risk and often less expensive than a colonoscopy. They are commonly used to diagnose colon cancer and inflammatory disease. But it doesn’t end there; barium enemas also help detect polyps, diverticulum (a pouch pushing out from the colon) and structural changes in the large intestine.

In order to conduct the most accurate barium enema test, you will need to follow a prescribed diet and bowel preparation (prep) before the test. Like a colonoscopy, this prep commonly includes restricted intake of dairy products and a liquid diet for 24 hours beforehand. You’ll also need to drink lots of water or clear liquids leading up to your barium enema.

Be sure to ask your doctor for simple, readable instructions for your procedure and prep. If you have any questions or apprehensions, be sure to ask your doctor before it’s barium enema time.

To begin a barium enema, your doctor will have you lie on your back on a tilting table so you can easily have x-rays taken of your abdomen. Then, you’ll be asked to lie on your side. At that point, a well-lubricated rectal tube is inserted through the anus. This tube allows your doctor to slowly administer the barium into the rectum and colon. Your doctor may also choose to use a rectal balloon to help retain the barium.

As the barium fills the intestine, x-rays of the abdomen are taken to distinguish significant findings and help detect abnormal growths. Your doctor will take x-rays from several different angles to see your whole colon. He or she may also ask you to move around on the table or turn over to help spread the barium sulfate through your colon and provide additional views. The process lasts for about 30 to 45 minutes.

If your doctor sees something suspicious during this test, he or she may order a follow-up colon cancer screening test, such as a colonoscopy.

While a barium enema is considered a safe screening test and is used on a routine basis, it can cause complications in certain people. Please keep these indications in mind before a barium enema is performed:

Those who have a rapid heart rate, severe ulcerative colitis, toxic megacolon or a presumed perforation in the intestine should not undergo a barium enema.
The test can be cautiously performed if the patient has a blocked intestine, ulcerative colitis, diverticulitis or severe bloody diarrhea.
Rare complications may include: perforation of the colon, water intoxication, barium granulomas (inflamed nodules) and allergic reaction.

For more information about barium enemas, please call the Colon Cancer Alliance’s Toll-free Helpline at (877) 422-2030.