Barium Enema

Barium enema is generally not useful in the diagnosis of chronic constipation48 and has been replaced by colonoscopy for the screening and evaluation of many diseases, including divertic-ular disease and colorectal cancer. However, it does have the advantage of providing a permanent record for future evaluation regarding the size, length, and anatomic abnormalities of the colon. In this sense, barium enema is probably superior to colonoscopy. High-quality double-contrast technique and inclusion of lateral rectal views are essential in a good study.

A large dilated (megacolon) elongated or redundant (dolichocolon) colon is frequently found in patients with constipation (Figs. 5.3 and 5.4). In fact, based on studies using continuous colonic perfusion and a dye dilution technique, colonic volumes were approximately 50% greater in constipated patiensts, as compared to controls.49 In clinical practice, however, mega-colon and particularly dolichocolon have been found in healthy individuals; thus, these findings are not truly indicative of severity or of the need for surgery. Normal ranges for the width of the colon can vary considerably, but the upper normal limit of the rectosigmoid in a lateral view of the pelvic brim has been considered as 6.5 cm.50 Therefore, barium or water-soluble enema is essential for the diagnosis of mega-colon. Similarly, dolichocolon is somewhat

Dolichocolon
Figure 5.3. Dolichocolon.
Dolichocolon
Figure 5.4. Megacolon.

poorly defined and has been considered as any case in which the enema-filled pelvic loop rises above a line drawn between the iliac crests.51 This condition occurs in approximately 50% of patients with a history of constipation exceeding 10 years, compared with 2% in the control group. Patients with a shorter history of constipation fall between these two values.52 Dolichocolon in constipation can be a reason for an incomplete colonoscopy.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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Responses

  • tove
    Is barium enema as good diagnostically as a colonoscopy?
    7 years ago

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