Name of the Procedure:

Colorectal Cancer Screening; Alternative to G0104, Screening Sigmoidoscopy, Barium Enema (G0106)
Common name(s): Colorectal cancer screening with barium enema
Technical/Medical term: Double-contrast barium enema

Summary

A double-contrast barium enema is a type of X-ray imaging test used to screen for colorectal cancer. The procedure involves filling the colon with a barium solution to enhance the visibility of the intestinal lining on X-rays.

Purpose

The primary goal of this procedure is to detect colorectal cancer, polyps, and other abnormalities in the colon and rectum. Early detection can lead to timely treatment and improved outcomes.

Indications

• Individuals aged 50 and older with average risk factors for colorectal cancer.
• Patients with a family history of colorectal cancer or polyps.
• Presence of symptoms such as rectal bleeding, chronic abdominal pain, or unexplained weight loss.

Preparation

• Patients are typically required to follow a clear liquid diet for 24 hours before the procedure.
• A bowel cleansing regimen, including laxatives and possibly an enema, is necessary to clear the colon.
• Any medications being taken should be discussed with the healthcare provider, as some may need to be temporarily discontinued.

Procedure Description

1. The patient lies on an X-ray table.
2. A small tube is inserted into the rectum, and a barium solution is introduced into the colon.
3. Air may be pumped into the colon to expand it and provide a clearer view.
4. X-ray images are taken from various angles as the barium outlines the inner surface of the colon.
5. The tube is removed, and the patient may need to evacuate the barium after the procedure.

Duration

The procedure typically takes about 30 to 60 minutes to complete.

Setting

The test is usually conducted in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nurse or medical assistant

Risks and Complications

• Discomfort or cramping during the procedure.
• Potential allergic reaction to barium.
• Risk of bowel perforation, though extremely rare.
• Temporary changes in bowel habits such as constipation or diarrhea.

Benefits

• Early detection of colorectal cancer and pre-cancerous polyps.
• Non-invasive and relatively quick procedure.
• Clear imaging that can reveal various abnormalities in the colon.

Recovery

• Patients can usually resume normal activities immediately after the procedure.
• It is important to drink plenty of fluids to flush the barium from the system.
• Bowel movements may appear white or light-colored for a couple of days.
• Follow-up with the healthcare provider for results and any additional recommendations.

Alternatives

• Screening colonoscopy: more invasive but can also treat abnormalities during the procedure.
• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT): less invasive but requires frequent repetition.
• CT colonography: non-invasive but involves radiation exposure and may require follow-up colonoscopy if abnormalities are detected.

Patient Experience

Patients may feel discomfort from the introduction of barium and air into the colon. Cramping or fullness is common during the procedure. Pain management includes deep breathing techniques and patient positioning adjustments. After the procedure, patients are encouraged to expel the barium and may experience changes in bowel habits temporarily.