When is air-contrast barium enema or Gastrografin study indicated in the workup of constipation?

Updated: Mar 30, 2020
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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An air-contrast barium enema is useful for assessing the possibility of an obstructing colon cancer, intermittent volvulus, or colonic stricture in the setting of chronic constipation. A barium study is preferable to a Gastrografin study for patients who do not present with an acute process. On the other hand, a Gastrografin study is preferable for patients with an acute abdomen because it prevents the risk of extravasation of barium into the peritoneal cavity through a perforated diverticulum or colon cancer.

In patients with suspected colonic obstruction, the author prefers to use colonoscopy rather than barium enema, but either modality may suffice.

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