In enteroclysis, a thin tube, or catheter, is inserted through your nose or mouth and passed through your stomach into the small intestine, or small bowel. Barium sulfate is infused directly into the small bowel; this contrast agent is opaque to x-rays and thus reveals any structural or tissue abnormalities on the x-ray images. Because the barium bypasses your stomachavoiding dilution by its digestive juicesenteroclysis can provide a more accurate picture of the small bowel than a small bowel series.
Purpose of the Enteroclysis
- To detect and evaluate Crohn's disease, an inflammatory condition affecting the last portion of the small intestine (ileum)
- To diagnose Meckel’s diverticulum, a sac that pushes through the wall of the small bowel
- To help identify the site of small bowel obstructions
- To aid in the diagnosis of tumors
Who Performs Enteroclysis
Special Concerns about Enteroclysis
- When perforation of the upper gastrointestinal tract is suspected, barium is not used because leakage of the dye could worsen any existing infection. A water-soluble contrast agent, diatrizoate (Gastrografin), is usually substituted.
- Pregnant women should not undergo this test because exposure to ionizing radiation may harm the fetus.
- Barium in the intestine from previous contrast x-rays, such as a barium swallow, may interfere with the results.
- Patients with unstable vital signs must be closely monitored during this test.
Before the Enteroclysis
- Be sure to inform your doctor of all drugs you regularly take. Some medications may need to be discontinued for 24 hours before the test.
- Tell your doctor about any known drug allergies or sensitivities.
- Do not eat, drink, or smoke after midnight on the day before the test.
- Tell your doctor or nurse if you have constipation; an enema may be necessary.
- You may be instructed to take a mild laxative or perform a mild cleansing enema on the day before the test.
- Remove any metallic objects, such as jewelry, watches, dentures, or hairpins, before the test begins.
- An intravenous (IV) catheter is inserted in a vein in your arm so that medications can be administered as needed during the procedure.
What You Experience during Enteroclysis
- You are asked to lie on your back on an x-ray table. Before the test begins, you may receive an IV sedative to relax you.
- Then you will sit up and the radiologist will use numbing spray to numb the back of your throat, reducing your gag reflex. A catheter is then passed through your nose or mouth. (A local anesthetic is usually sprayed inside your nose or throat to make the catheter insertion more comfortable.)
- With the aid of fluoroscopy, which transmits continuous, moving x-ray images onto a viewing screen, the radiologist guides the catheter through your stomach and into the initial portion of the small bowel.
- A small balloon at the tip of the catheter is inflated to prevent barium from flowing back into your stomach.
- Barium is administered through the catheter. (In some cases, the bulking agent methylcellulose is also given to distend the walls of the small bowel further and provide a clearer picture of the area.) You may feel a sensation of fullness in your abdomen.
- The radiologist observes the flow of barium through the small bowel via fluoroscopy.
- At various points during the exam, you will be instructed to move into different positions as spot x-ray films are taken of any abnormalities. As each x-ray is taken, you should hold your breath and remain as still as possible.
- Once the exam is completed, the doctor deflates the balloon and removes the catheter.
- The procedure takes about 1 hour.
Risks and Complications of Enteroclysis
- Although radiation exposure is minimal, you receive a higher dose of radiation than during standard x-ray procedures.
- In rare cases, an allergic reaction to medications prescribed for the examination may occur.
- Very rarely, injury to bowel structures may occur during the study.
- The barium may accumulate and block the intestines if it is not excreted within a few days. Contact your doctor if the barium has not passed through your system within 2 or 3 days following the test.
After the Enteroclysis
- Your vital signs are monitored in a recovery area until you are alert.
- If you received a sedative, someone should drive you home.
- If a local anesthetic was administered inside your throat, do not eat or drink until your gag reflex returns, usually in a few hours. (Touching the back of the throat with a tongue depressor tests for this reflex.)
- Drink plenty of fluids to help eliminate the barium. Your doctor may also give you a mild laxative to purge your body of the contrast agent.
- Your stool will be chalky and light-colored initially, but should return to normal color after 1 to 3 days.
- The doctor will examine the recorded x-ray images for evidence of any abnormality.
- If a definitive diagnosis can be made, appropriate treatment will be initiated.
- In some cases, additional tests, such as a small bowel biopsy, may be needed to further evaluate abnormal results.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media