Enteroclysis is an x-ray of the small intestine that looks at how a liquid called contrast moves through the area.
Small bowel enema
How the test is performed
This test is done in a hospital radiology department. The health care provider will insert a tube through your nose or mouth into your stomach and into part of the small bowel. Contrast (usually barium) and air flow through the tube, and x-rays are taken.
The x-ray images appear on a monitor similar to a television screen in "real time," which means they are seen as the contrast is actually moving through bowel structures.
X-rays are a form of electromagnetic radiation, as is light. They have higher energy than light, however, so they can penetrate the body to form an image on film. Areas that are dense look white, areas that are less dense look black, and other areas will be shades of gray. The contrast used for this test is dense and can be seen clearly on x-ray.
The goal of the study is to image all of the loops of small bowel. Both "real time" pictures and still images are taken. You may be asked to change positions during the exam. The test usually lasts several hours, since it may take a while for the contrast to move through the entire small bowel.
How to prepare for the test
A clear liquid diet is suggested for at least 24 hours before the test. Laxatives may be prescribed to make sure the bowel is clear of any particles that might interfere with the study.
Medications, including narcotic pain relievers, which slow down the digestive system, may need to be stopped on or before the day of the exam. Your health care provider will give you instructions regarding any changes to medications. Do not change or stop taking any medications without consulting your health care provider.
If you are anxious about the procedure you may be given a sedative before it starts. You will be asked to remove all jewelry and to wear a hospital gown.
How the test will feel
The placement of the tube may be uncomfortable. The contrast material may cause a feeling of abdominal fullness.
Why the test is performed
This test is performed to examine the small bowel. It is the most complete way of telling if the small intestine is normal.
There are no problems seen with the size or shape of the small intestine. Contrast travels through the bowel at a normal rate without any sign of blockage.
What abnormal results mean
There are many abnormalities of the small intestine that may be identified with enteroclysis. Some of these include:
What the risks are
The type of radiation exposure is similar to other x-ray procedures. However, the radiation exposure may be greater with this test than with other types of x-rays because of the length of time needed for the fluoroscopic examination. Most experts feel that the risk is low compared with the benefits.
Pregnant women and children are more sensitive to the risks of x-ray radiation. If there is a chance that you are pregnant, you must inform your health care provider, and an appropriate decision will be made regarding the necessity of the procedure.
Rare complications include allergic reactions to medications prescribed for the examination. You should consult with your health care provider to determine any known drug sensitivities. Another very rare complication is possible injury to bowel structures during the study.
Barium may cause constipation. Consult your health care provider if the barium has not passed through your system by 2 or 3 days after the test.
This test may not be able to see some parts of the intestine because of the position of the tube. An alternative may be an abdominal CT scan.
Neil Grossman, MD, MetroWest Radiology Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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