Irrigoscopy of the intestine
Many have heard of colonoscopy of the intestine, but barium enema is less widely known. Let’s talk about this method of examination in more detail together with experts

Colon diseases occur in people of all ages. Modern research methods, including irrigoscopy, help to make an accurate diagnosis. However, most patients have not heard of this procedure or do not know why and how it is performed.

We spoke with our experts about how colonoscopy is performed and what it is used for. They also learned how to prepare for the procedure, what diet to follow and what drugs to take.

What is an irrigoscopy of the intestine

Irrigoscopy is an x-ray examination of the large intestine, which helps to diagnose diseases and developmental anomalies. The procedure is performed using an x-ray contrast agent based on barium sulfate or sodium amidotrizoate. It is administered with an enema, after which x-rays (irrigograms) are taken.

The radiopaque mixture fills the intestine and helps visualize all parts of the mucosa. Thanks to this, the doctor can assess the location, thickness and structure of the intestinal walls, see the narrowing and expansion of the lumen, foreign bodies and neoplasms. If necessary, double contrasting is used: after emptying the intestines, it is filled with air and a series of images is taken again.

The x-ray contrast mixture does not dissolve, but is excreted from the body unchanged within a few days after the procedure.

Indications for irrigoscopy of the intestine

An x-ray examination of the large intestine is prescribed by a doctor to identify or rule out problems characteristic of this section of the gastrointestinal tract. Previously, the patient is prescribed other examinations: blood and urine tests, ultrasound of the abdominal cavity. Based on the results of the examinations, the doctor decides on an intestinal irrigoscopy1.

X-ray examination is indicated for patients who have previously been diagnosed with the following conditions:

  • polyps and other neoplasms;
  • Crohn’s disease;
  • diverticulosis;
  • dolichosigma;
  • intestinal obstruction;
  • ulcerative and ischemic colitis;
  • the presence of foreign bodies;
  • Hirpshrung’s disease.

Patients with these diseases usually complain of standard symptoms: stool disorders, flatulence, pain and heaviness in the abdomen, pain during defecation, blood in the stool. However, the doctor will not prescribe an x-ray based on symptoms alone, but will refer the patient for a preliminary examination. X-ray is most often used to clarify the diagnosis and assess the need for surgery.2.

Contraindications for colonoscopy

Irrigoscopy of the intestine has contraindications, like most medical procedures. X-ray examination is not recommended for pregnant women, people allergic to contrast material, and patients after recent surgery.

Radiography is contraindicated in people with severe cardiovascular disease, progressive ulcerative colitis, and toxic megacolon.

Preparation for irrigoscopy of the intestine

Proper preparation for irrigoscopy of the intestine largely affects the result of the procedure. X-ray examination will be useless if there are feces and food debris in the lumen of the large intestine. Therefore, before irrigoscopy of the intestine, they follow a diet and perform cleansing procedures.3.

Diet

The diet before colonoscopy should be low-slag. Weak broths, low-fat sour-milk products except cottage cheese, white fish and dietary meats are allowed: chicken breast, rabbit and turkey. Foods that cause gas formation are excluded from the diet:

  • fresh vegetables – cabbage, legumes, beets;
  • greenery;
  • fresh fruits – bananas, apples, apricots, oranges;
  • Rye bread;
  • oatmeal, pearl barley and wheat porridge.

You need to eat fractionally in small portions, and cook food for a couple or boil. It is recommended to drink up to 2 liters of liquid – fruit drinks, compotes, ordinary water and weak tea. Lunch on the eve of the procedure should be light, dinner and breakfast should be discarded.

Preparations

Preparation for barium enema includes taking laxatives that speed up the cleansing of the large intestine. The doctor prescribes the drug and the dosage regimen. As laxatives, Fortrans, Dufalac, Endofalk, Picoprel are often used.

2-3 days before the procedure, you need to stop taking drugs that increase or decrease intestinal motility. These drugs include papaverine, no-shpa, drotaverine, metoclopramide, halidor.

Enema

Cleansing enema is done in the evening and in the morning. During the procedure, 2–2,5 liters of liquid are gradually introduced into the intestines. Enemas are repeated until the water becomes clear without admixture of feces. The cleansing procedure is not indicated for everyone, for example, it is not performed by patients with gastrointestinal bleeding and ulcerative colitis.

Where is an intestinal irrigoscopy performed?

This is a non-invasive procedure that is done in the x-ray rooms of hospitals and outpatient clinics. X-ray examination is performed in clinics, hospitals and diagnostic centers.

How is an intestinal irrigoscopy performed?

During the procedure, the patient lies on the X-ray table. First, an x-ray of the intestine is taken without contrast to make sure that there are no waste products. Then, a tube is inserted into the anus of the patient, through which a solution of a radiopaque substance heated to 34–36 ° C enters. When the bowel is filled with contrast material, x-rays are taken from several positions. After that, the intestines naturally empty.

With barium enema using the method of double contrasting, another procedure is performed – the colon is filled with air and irrigograms are made again. The entire procedure takes an average of 40-60 minutes.

How much does an intestinal irrigoscopy cost?

The procedure can be done free of charge under the CHI policy. The cost of barium enema in private diagnostic centers and clinics varies depending on the region, the equipment used and the complexity of the procedure. For example, in Moscow, you will need to pay an average of 6000–12000 rubles for an examination. In other cities, prices start from 1000-1500 rubles.

Popular questions and answers

Irrigoscopy is considered a safe and informative research method and is often used to diagnose pathologies of the large intestine. Therefore, many are interested in how safe and painless this procedure is and how it differs from another popular research method – colonoscopy. Our experts answer popular questions from readers: candidate of medical sciences, doctor of the highest category, therapist Yulia Esipenko и Candidate of Medical Sciences, doctor of the highest category surgeon Maksud Magomedov.

What is the difference between colonoscopy and colonoscopy?

Both diagnostic methods allow assessing the condition of the large intestine and identifying pathological processes. But they are fundamentally different in the way they are carried out. Irrigoscopy is a study using a radiopaque substance that fills the large intestine. Colonoscopy is performed using a colonoscope – endoscopic equipment with optics, which provides high-definition images when examining tissues and sections of the intestine.

 

Colonoscopy is a more informative method, since it can be used to assess the condition of the peri-intestinal lymph nodes, to detect the most minor pathological changes, including malformations and tumors. During the examination, other medical procedures can be performed, such as stopping bleeding or taking tissue for a biopsy.

 

Irrigoscopy allows you to quickly and accurately examine the large intestine, including those departments where the colonoscope does not reach. Thanks to the contrast agent, the doctor receives a clear picture, which can be used to assess the anatomy of the intestine and the presence of large pathological formations. However, barium enema is difficult and often impossible to detect inflammation, a small polyp or tumor at an early stage.

Will it hurt during an intestinal irrigoscopy?

According to patients, irrigoscopy of the intestine is a painless procedure. Some discomfort may occur when the bowel is filled with a radiopaque substance using an enema. During the examination, the urge to defecate and a feeling of heaviness in the abdomen are possible.

What should be done after an irrigoscopy?

After the procedure, they lead a normal life. Do not worry if within 2-3 days the stool will be lighter – this is due to the release of barium residues. Short-term constipation may occur, so a single dose of a laxative is allowed.

What complications can occur?

Complications during and after irrigoscopy are extremely rare. Sometimes, when the intestinal walls are stretched, abdominal pain and painful urge to stool appear, which disappear within 2-3 hours and do not require treatment. To relieve pain, you can take an antispasmodic.

 

A very rare and more serious complication is intestinal perforation and the release of a radiopaque substance into the abdominal cavity. In this case, there is nausea, vomiting, weakness, fever, abdominal pain, diarrhea and bleeding from the rectum. With such symptoms, you should immediately consult a doctor.

Sources of

  1. Ирригоскопия. Памятка для пациента http://nmcs.ru/infopat/diagnostics/%D0%98%D1%80%D1%80%D0%B8%D0%B3%D0%BE%D1%81%D0%BA%D0%BE%D0%BF%D0%B8%D1%8F.pdf
  2. Radiation diagnosis of diseases of the esophagus, stomach and intestines. https://disk.yandex.ru/i/4cYCbOkWs5GzjA
  3. The order of preparation for conducting x-ray studies. https://disk.yandex.ru/i/K19kT5_kXU4sIg

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