A Barium Enema is a specialized X-ray procedure used to examine the large intestine, including the colon and rectum, to diagnose structural or functional abnormalities. Unlike other barium studies that involve swallowing the contrast, in a barium enema, a liquid barium sulfate solution is introduced into the colon through the rectum using an enema tube. The barium coats the lining of the colon, making it visible on X-ray images. As the barium fills the colon, a series of X-rays or fluoroscopic images are taken to observe the shape, size, position, and condition of the colon walls. The patient may be asked to move into different positions to ensure the barium spreads evenly and all parts of the colon are visualized. In some cases, air is also introduced after the barium to provide a double-contrast barium enema, which enhances the visibility of the mucosal lining and helps detect polyps, tumors, diverticula, inflammatory bowel disease, strictures, or other abnormalities. This procedure is especially useful in evaluating chronic constipation, rectal bleeding, changes in bowel habits, or suspicion of colorectal cancer. The exam typically takes 30 to 60 minutes and may cause temporary cramping or discomfort due to bowel distension. After the procedure, patients are advised to drink fluids and may have pale stools until the barium is fully eliminated from the body. While barium enemas are less commonly used today due to the rise of colonoscopy and CT colonography, they still serve as an important diagnostic tool in certain clinical situations.

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