What is the role of barium contrast studies in the diagnosis of Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Barium enema is noninvasive and usually well tolerated for evaluating features such as pseudodiverticula, fistulization, and the severity and length of colonic strictures. SBFT and enteroclysis may be valuable in demonstrating the distribution of small bowel disease in a patient presenting with suspected IBD. Mucosal fissures, bowel fistulae, strictures, and obstructions can be visualized. The terminal ileum may be narrowed and thickened, with a characteristic pipe appearance.

However, barium studies are contraindicated in patients with known perforation, and water-soluble agents should be used in place of barium. Barium can also cause peritonitis. Although in the past, barium contrast studies were the imaging modalities of choice for Crohn disease, these studies now are less commonly used, with the advent of new and more detailed CT, MRI, and capsule endoscopy techniques to assess for small bowel and pelvic Crohn disease.

For more information, see Imaging in Crohn Disease.

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