Name of the Procedure:

Colorectal Cancer Screening via Barium Enema\ Common name(s): Barium Enema Screening\ Technical/Medical terms: Colorectal Cancer Screening, Alternative to Screening Colonoscopy, Barium Enema (G0120)

Summary

A barium enema is an X-ray exam that can detect changes or abnormalities in the large intestine (colon). This screening method uses a contrast material called barium to visualize the colon and is an alternative to screening colonoscopy.

Purpose

• Medical Conditions: Detects colorectal cancer, polyps, and other abnormalities in the colon.
• Goals: Early detection of colorectal cancer and other gastrointestinal conditions to enable timely intervention and treatment.

Indications

• Symptoms such as blood in stool, unexplained weight loss, or prolonged bowel habit changes.
• Family history of colorectal cancer.
• Screening for patients unable to undergo colonoscopy.

Preparation

• Pre-procedure Instructions: Follow a clear-liquid diet for a day before the procedure, and take prescribed laxatives to empty the bowel.
• Diagnostic Tests: Pre-procedure evaluation may include a medical history review and possibly blood tests.

Procedure Description

1. Patient Positioning: The patient will lie on their side on an X-ray table.
2. Barium Administration: A lubricated tube is inserted into the rectum, and barium contrast material is introduced into the colon.
3. X-rays: Multiple X-ray images are taken as the barium flows through the colon, highlighting any abnormalities.
4. Air Introduction (optional): Air might be pumped to expand the colon for clearer images.
5. Completion: The tube is removed, and the patient is taken to a restroom to expel the barium.

Duration

Typically takes about 30 minutes to 1 hour.

Setting

Usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

• A radiologist (specialist in medical imaging)
• Radiologic technologist
• Possibly a nurse for assistance

Risks and Complications

• Common: Mild abdominal discomfort or cramping, residual barium in stool for a day or two.
• Rare: Bowel perforation, allergic reaction to barium, infection.

Benefits

• Non-invasive way to detect colorectal cancer and other abnormalities.
• Offers an alternative for patients who cannot undergo a colonoscopy.
• Quick and usually well-tolerated procedure.

Recovery

• Post-procedure Care: Drink plenty of fluids to help clear the barium from your system. You may have white stools for a few days.
• Recovery Time: Most patients can resume normal activities immediately, but should avoid strenuous activities for a day.
• Follow-up: A follow-up appointment may be recommended to discuss the results and any necessary further testing.

Alternatives

• Colonoscopy: More comprehensive but requires sedation.
• Fecal Occult Blood Test (FOBT): Less invasive but less detailed.
• CT Colonography: Slightly more detailed imaging but involves radiation exposure.

Patient Experience

• Patients typically feel minor discomfort due to the bowel preparation and the insertion of the tube.
• Some may feel bloated or have cramping during the procedure.
• Pain management is generally not required as the procedure is minimally invasive and discomfort is usually mild.