The double contrast barium enema is rapidly being replaced by CT colonography, but remains in some centres for:
- the detection of polyps and colorectal cancer
- follow up screening for postoperative colorectal cancer
- evaluation of diverticular disease
- failed colonoscopy
- investigation of non-specific abdominal pain
The barium enema procedure is contraindicated in certain conditions:
- toxic megacolon
- pseudomembranous colitis
- imminent rectal biopsy within 7 days of procedure or within 7 days after the rectal biopsy.
The 'double contrast' refers to the use of positive and negative contrast agents to increase the sensitivity of the examination.
The double contrast study is sensitive to visualize mucosal irregularities.
- positive contrast: barium or barium-like agent, e.g. Gastrografin ®
- negative contrast: air or CO2
- duodenal ulcer
- small bowel
- colonic narrowings