Air Contrast Barium Enema and Colon Cancer Screening Fact Sheet

Cancer in the colon develops in almost one of every 20 adults. Older adults are significantly more at risk for the disease. Regular screening is an effective way to prevent deaths as early detection of colon cancer results in a very high survival rate. One of the tools for early detection is an air contrast barium enema. This relatively simple test can alert a doctor to the existence of pre-cancerous growths or lesions that could develop into cancer of the colon, or identify signs of existing cancer that need immediate treatment.

Overview of the Test

An air contrast barium enema test involves pumping a harmless substance called barium sulfate into the colon, followed by a blast of air. Barium is a thick, white liquid that will coat the lining of the intestines so that doctors can use an x-ray to see if there are any projections or bumps where there shouldn’t be.

Barium enemas may not only show possible signs of cancer, they may also diagnose digestive tract issues. The barium makes it easier to see the large intestine and colon to assess intestinal health. The blast of air widens the colon for better viewing.

How it is done

An air contrast barium enema is a multi-step procedure. It begins with a patient lying sideways on an examining table so that the technologist can easily access the rectal opening. A technologist will first take what is known as a scout film. A doctor then looks at the picture to ensure that the colon is clean and ready for the test.

A technologist then inserts the enema tip into the anus. This allows the barium to flow into the rectum. The doctor will allow enough barium into the colon to coat the walls. A patient will roll onto his or her other side, and then back again, possibly several times. The movement helps the barium to coat the entire lining of the colon.

Air is then pumped into the rectum through the enema tip. This widens the walls of the colon, allowing the doctor to better examine it. X-rays are then taken of the colon. The images are examined by the doctor. More pictures may be taken. The patient is then asked to use the restroom to get the barium out of the body. This is followed by another set of X-rays. The entire process usually takes at least 45 minutes.

Who does it?

A technologist generally performs the initial procedure while a doctor oversees and views the film. A radiologist takes the X-rays.


A barium enema can be expensive, but the cost varies by doctor and area. Health insurance covers part of the costs of an enema in most cases. A co-pay may be between $50 and $150 for barium enemas. People who do not have insurance could pay anywhere from between $200 to $2,000 for barium enemas.

When and How Often?

The risk of colon cancer increases after the age of 50. Therefore, anyone over the age of 50 should get screened every five years. This could include an air contrast barium enema, flexible sigmoidoscopy, fecal occult blood, or a colonoscopy.

A doctor may order an air contrast barium enema when there are symptoms affecting the digestive system that do not have a known cause. Symptoms that could lead to a barium enema include rectal bleeding, abdominal pain or changes in bowel movements. This test is sometimes used to diagnose diverticulitis, which is when a small portion, or portions, of the colon is inflamed.


Barium enemas rarely cause complications. Patients sometimes have white stools for days following their enema. It is important to drink increased amounts of water or other liquids for a day or two after a barium enema. Some people do experience constipation after an air contrast barium enema. A doctor could prescribe a mild laxative if constipation occurs.


  • Cedars-Sinai
  • Health.CostHelper
  • Fast Living Slow Ageing; Kate Marie and Christopher Thomas; 2009

Last Reviewed 14/Mar/2014


Related Posts

The following two tabs change content below.
Whilst wielding a couple of dumbbells in a gym class in 2003, Kate experienced an epiphany around the lack of accepted best practice guidelines when it came to staying well and avoiding disease. Kate realized that she had no chance of slowing her own aging process unless she became better educated about her options.

Latest posts by Kate Marie (see all)