A barium enema is a fluoroscopic examination of the large intestine where the entire cavity of the colon is filled with barium and abdominal x-rays are taken.

How the Test is Performed

This test is done after the colon is completely empty. Your doctor will give you instructions on how to empty the colon.

You will lie on the x-ray table and an x-ray will be taken.

• You will then be told to lie on your side. The health care provider will gently insert a well-lubricated tube (enema tube) into your rectum. The tube is connected to a bag that holds a liquid containing barium sulphate. A small balloon at the tip of the enema tube may be inflated to help keep the barium inside your colon.

The health care provider will monitor the flow of the barium on an x-ray fluoroscopy screen.

There are two types of barium enemas:

• Single contrast barium enema uses barium to highlight your large intestine.
• Double contrast barium enema uses barium, but also delivers air into the colon to expand it. This allows for even better images.

You will be asked to move into different positions and the table will be slightly tipped to get different views. At certain times when the x-ray pictures are taken, you will hold your breath and be still for a few seconds so the images are not blurred.

The enema tube will be removed after the pictures are taken. You will be given a bedpan or helped to the toilet, so you can empty your bowels and remove as much of the barium as possible. One or two x-rays may be taken after you use the bathroom.

How to Prepare for the Test

You must completely empty your bowels before the exam. This may be done using an enema or laxatives combined with a clear liquid diet. Your health care provider will give you specific instructions. Thorough cleaning of the large intestine is necessary for accurate pictures.

How the Test Will Feel

When barium enters your colon, you may feel like you need to have a bowel movement. You may also have a feeling of fullness, moderate to severe cramping, and general discomfort. Try to take long, deep breaths during the procedure. This may help you relax.

An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine.

How the Test is Performed

You may be given an injection of a medication that will temporarily slow muscle movement in the small intestine, so structures can be more easily seen on the x-rays.

Before the x-rays are taken, you must drink a cup of a milkshake-like drink that contains a substance called barium, which shows up well on x-rays.

Fluoroscopy tracks how the barium moves through your oesophagus, stomach, and small intestine. Pictures are taken with you in a variety of positions. You may be sitting or standing.

The test can take 30 minutes for a Barium swallow or can be up to 3-6 hours for a complete follow through of the intestines.

How to Prepare for the Test

You may be told to change your diet for the test.

Be sure to ask your health care provider if there are any medication restrictions. Generally, you can continue taking medications you take by mouth. Never make any changes in your medications without first talking to your health care provider.

You will be asked to remove all jewellery on your neck, chest, or abdomen before the test.

How the Test Will Feel

The barium drink may cause mild bloating but usually causes no discomfort.

A Voiding Cystourethrogram (VCUG) is an x-ray examination of a patient’s bladder and lower urinary tract that uses fluoroscopy and a contrast agent. A VCUG enables the radiologist to detect abnormalities in the flow of urine from the bladder through the urethra. The examination is requested in paediatric and adult patients.

About Vesicoureteric Reflux

Urine is produced in the kidneys and flows through the ureter, the tube that carries urine from each kidney to the bladder. A valve mechanism prevents urine from backing up into the kidneys as the bladder gets full. Urine leaves the bladder through the urethra and is eliminated from the body during urination.

In some children, an abnormality in the valve or the ureters allows urine to flow backwards, a condition called VU reflux. In mild cases urine backs up into the lower ureter. In severe cases it can back up into a swollen kidney. Usually, children with this condition are born with it but there may be other causes. A urinary tract infection may be the only symptom of the problem.

How the Test is Performed

The radiographer begins by positioning you on the table. Infants and young children may be wrapped tightly in a blanket to help them lie still during the imaging. An x-ray of the abdomen is performed.

After cleaning the genital area, a catheter is inserted through the urethra, (the tube that carries urine from the bladder out of the body), into the bladder. Then, the bladder is filled with a water-soluble contrast material. Using fluoroscopy, the radiologist will obtain images of your bladder filling and emptying. The radiologist and/or the radiographer will check to see if any of the liquid goes backward into one or both ureters and whether the shape and contour of the bladder and urethra are normal.

When the bladder is full, the radiologist will remove the catheter. We will ask you to urinate into a container. This may be difficult, especially for children but it’s important. Babies will urinate on their own when the bladder is full. X-rays will be obtained during the monitoring.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. A voiding cystourethrogram is usually completed within 30 minutes.

How to Prepare for the Test

You should inform your doctor of any medications that you are taking and if you have any allergies, especially to contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
You may be asked to wear a gown during the exam and to remove all jewellery.
There are no restrictions on eating or drinking before the exam.

A hysterosalpingogram is an x-ray examination of a woman’s uterus and fallopian tubes. The examination is most often requested when patient’s have difficulty becoming pregnant. The test demonstrates whether there is any blockage of the fallopian tubes and any abnormalities within the uterus such as abnormal shape or structure, tumours, ahhesions, scarring or fibroids.

How the Test is Performed

The procedure is similar to a gynaecological clinical examination. The radiographer begins by positioning you on the examination table with your knees bent. A speculum is inserted into the vagina and a thin catheter is placed into the cervix. Contrast material is then injected via the catheter and is seen filling the uterine cavity, fallopian tubes and peritoneal cavity (space between your organs and abdominal wall). Flouroscopic images are taken during and after contrast injection. The speculum and catheter are both removed once the images are acquired.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. A hysterosalpingogram is usually completed within 30 minutes.

There may be temporary discomfort during insertion of the catheter and injection of the contrast. Slight irritation of the peritoneum can cause lower abdominal pain, but this should be minimal. Vaginal spotting can be expected for a few days after the procedure.

How to Prepare for the Test

The procedure is best performed one week after menstruation, but before ovulation – around day 10 after bleeding commences. The timing of the procedure is to ensure that you are not pregnant during the examination. It is ideal to make an appointment for your procedure.

The procedure should NOT be performed in the presence of acute or chronic pelvic infection. Your doctor will need to treat your infection first.

You should inform your doctor of any medications that you are taking and if you have any allergies, especially to contrast materials.

You may be asked to wear a gown during the exam and to remove all jewellery.  There are no restrictions on eating or drinking before the exam.

Fluoroscopy is also extensively used in image guided interventional procedures such as lumbar puncture, biopsy, abscess drainage, nephrostomy and facet block injections. Details on these procedures are included under Non-vascular Interventional Radiology.