Double-contrast barium enema
A double-contrast barium enema (also called DCBE or barium enema) uses X-rays to find abnormal growths in the colon. It is a form of colorectal cancer screening.
The details
- Examines the colon using X-rays
- Can detect polyps and other abnormalities in the colon
- Requires no sedation
- Is usually less expensiveoption to colonoscopy
- Uses X-rays to find abnormal growths in the colon
Barium, a silver-white metallic compound, is used to outline the colon and rectum on the X-ray. Air is then passed through the same tube to further enhance the X-ray.
DCBEs are commonly used to diagnose colorectal cancer and inflammatory disease. They can also help detect polyps, diverticulitis, and structural changes in the large intestine.
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The prep
- You will need to follow a prescribed diet and bowel prep before the test.
- Like a colonoscopy, this prep commonly includes restricted intake of dairy products and a liquid diet for 24 hours beforehand.
- You’ll also need to drink lots of water or clear liquids leading up to your barium enema.
The procedure: what to expect
- You will lie on a tilting table so you can easily have X-rays taken of your abdomen.
- Next, a well-lubricated rectal tube is inserted through the anus. This tube allows your doctor to slowly administer the barium into the rectum and colon.
- Your doctor may also choose to use a rectal balloon to help keep the barium inside.
- As the barium fills the intestine, X-rays of the abdomen are taken.
- Your provider will take X-rays from several different angles to see your whole colon.
- They may also ask you to move around on the table or turn over to help spread the barium sulfate through your colon and provide additional views.
- The process lasts for about 30 to 45 minutes.
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Will my insurance cover it?
Many plans cover it, socheck with your policy holder. Medicare varies, as sometimes this procedure may be substituted for a colonoscopy.
Pros & cons
Advantages
- No sedation required
- Very low risk
- Identifies lesions in the entire colon
- Accurate for finding abnormalities
- Can find cancer in earliest stage, when most treatable
- Slight risk of perforation
- Less expensive option to colonoscopy
Disadvantages
- Polyps cannot be removed during the procedure — you will need to get a colonoscopy if abnormalities are spotted on X-rays
- Requires laxative preparation
- Some may find the test uncomfortable
- Availability is decreasing; usually only for those who cannot undergo colonoscopy
- Uses X-ray radiation
- Not always covered by insurance
Who decides who pays for screening
Not sure which screening is for you?
How to talk to your doctor about screeningTop resources
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