Lower Bowel Series - What to expect?

[xJillx]

Hi All!

I have been having daily abdominal pain, so I am going to have my first lower bowel series to investigate. My doctor orignally wanted an MRE, but insurance gave us a hard time. Anyways, has anyone had this done and what am I to expect? Is there any prep needed? I haven't had much luck finding out about the test online. Also, what will the test show? I am assuming my GI is looking for inflammation, but is it more detailed than that?

Thanks!

 

[moogie]

Is that test the one they put barium inside and fill you up with air?

 

[xJillx]

Is that test the one they put barium inside and fill you up with air?

I don't know, but I hope not. That sounds pretty awful. ANd fill me up with air? I am a gassy girl already!

 

[BLM]

Not in my experience....if its the small bowel follow through series its not too bad. You cant eat for 12 hours prior and when you get there you have to drink barrium. Then they take xrays every 20 mins until the barrium reaches the small intestine. Your poo will be white and the barrium dehydrates you. So drink lots of water before and after your test. The first time I had it done it took 1 1/2 hours and the second time I did it, it took almost 6 hours....due to blockage and narrowing. I hope its easy for ya. The barrium can cause cramping and that can hurt pretty bad. Maybe a good idea to have some pain meds on hand if you need them. Good luck Jill, let us know how it goes

 

[dreamintwilight]

Yeah...the lower GI series is also known as the barium enema, sorry to say. I've had this along with a small bowel follow-through and several CT scans. The lower GI series was, in my opinion, the "worst" of them all.

I don't want to scare you, but I will share with you what my experience was. I had a lower GI series while I was in the hospital for an abscess. This was one of the procedures I had done while in the hospital that helped reached my diagnosis. I wasn't told much about this procedure, which I can't decide was a good or bad thing, haha. I think I would have rather been more prepared mentally for it, but perhaps I would have just worried more about it.

Anyway...I was happy to find out there was no oral prep I had to take for it. But, you do have to fast for it. I'm not sure for how long because I had been NPO (nothing by mouth) for at least 12 hours prior, so I was somewhat dehydrated for the procedure, which explains some of the aftermath I experienced.

I had to remove my shorts and underpants, so I was only wearing my gown. I laid on my left side and the girl told me she was going to insert the scope slowly and then during thex-ray they would fill my lower bowel up slowly while the doctor watched on the screen and took pictures. It wasn't too bad at first and was kinda cool because I could watch on the screen and the doc was pointing out things for me to look at. But, it got to a point where I was so full and I started having terrible cramping. Also, your bowel is naturally going to want to expel all that air and fluid out, which adds to the discomfort.

The cramping was quite unbearable near the end, but it could have been worse for me because my narrowing was so tiny - the size of a pea. So, it may not be as uncomfortable if you don't have significant narrowing.

Well, afterwards, was embarassing because I could no longer hold all of the liquid and gas inside and I ended up going all over myself on the table. There was a bathroom in the exam room that the girl quickly helped me run to. I felt bad because it trailed all over the floor as I made my way there.

Afterwards, like I said, I was already without food and then expelling all that extra liquid and not having any water for 12 hours I almost fainted leaving the bathroom and getting on the stretcher to go back to my room.

So, yeah...for me it was my worst exam, but I don't believe it's that bad for everyone. I just had extra circumstances that made it more uncomfortable. They will use either a barium contrast or a non-barium contrast depending on if they suspect a blockage risk. I had the non-barium contrast, which acted as a diuretic as opposed to the constipating effect barium has.

Sorry for all the detail, but I guess you can be prepared for the worst case scenario.

If you Google "barium enema" you may find more info or "lower GI series." The contrast will glow on the x-ray so the doctor will be able to see how narrow your bowels may be if you have inflammation. Could also show if you have any fistulas (tears in the intestinal lining).

Hope this was helpful!

 

[xJillx]

Thanks, everyone, for the information. I have got to be honest, I have yet to set up the appointment! But not because it sounds scary. The main reason I haven't yet is the pain I had been experiencing for about 4 weeks (it was mild but ever present) has really gone away almost entirely. I received the referral late Friday afternoon, and called to set up the appointment, but the radiology dept. was gone for the day. But then I felt good Saturday, better Sunday, and I am still doing well. Is this odd for pain to just dissappear?

So, I thought I'd wait another few days to see how I feel. I don't want to expose myself to radiation if not needed. Also, my insurance has been a real pain, and I don't want to get the test done now when everything may be okay and have them deny me in the future when it is really needed. Do you think I am making the right decision in waiting?

 

[dreamintwilight]

That is a tough decision, Jill. I know with Crohn's it is very common to have flares in pain. You can go from feeling great to feeling like total crap from day to day. If you do have inflammation, it would be good to know and get it treated right away. Otherwise, it could cause a gamut of more serious problems down the road (strictures, scar tissue, fistulas, abscesses, etc.).

I understand not wanting to put yourself through radiation if possible, unfortunately with something like Crohn's it's necessary to know exactly what's going on since it's hard to tell from the outside. When I was admitted to the hospital (pre-diagnosis) I had 3-4 CT scans in a 2 week time frame. A few months later I went back in to the hospital for a partial obstruction because the medications I was on weren't strong enough and had to get another CT scan and the small bowel follow-through, which uses regular x-ray rather than the CT radiation. I'm scheduled to get a CT scan this Friday to check on the progress of my disease. After that, my GI doc says it should be the last CT scan he wants me to have done for a while.

So, you have to weight the benefits with the risks. Get the procedure done and find out the extent of the inflammation and treat it properly to avoid complications or worsening or wait it out and possibly suffer worse if it comes back without proper treatment. If you get the procedure done now and treat the inflammation, you could avoid getting more CT scans down the road or at least extend the time in between if your condition stays stable, you know?

Only you can really decide if it's the right decision for you. Though, I will say, if your doc recommended you get an x-ray of some kind, they probably have some reason to want it done. Most docs don't want to just expose you to unnecessary amounts of radiation if it's not needed. Good luck! Keep us posted.

 

[xJillx]

Not in my experience....if its the small bowel follow through series its not too bad. You cant eat for 12 hours prior and when you get there you have to drink barrium. Then they take xrays every 20 mins until the barrium reaches the small intestine. Your poo will be white and the barrium dehydrates you. So drink lots of water before and after your test. The first time I had it done it took 1 1/2 hours and the second time I did it, it took almost 6 hours....due to blockage and narrowing. I hope its easy for ya. The barrium can cause cramping and that can hurt pretty bad. Maybe a good idea to have some pain meds on hand if you need them. Good luck Jill, let us know how it goes

Well, I set up the appointment! And, Bev, you are right on. A lower bowel series is not to be confused with a lower GI series. As you said, I only need to fast 12 hours before and I'll drink the barium at the hospital right before. They'll take x-rays as it works through my system. I was warned it could take several hours depending on how quickly (or slowly) my system moves. But I am happy because this test sounds a lot easier than a lower GI series! I'll let you guys know how it goes. Wish me luck!

 

[Misty-Eyed]

Oh you are lucky it's not a barium enema then! I had a few years ago and they aren't bad. I don't even think they tasted that bad, either. It's just boring to sit there all day waiting for it to get to where they want it to be. Just be prepared clean your toilet out well afterwards. That stuff seems to turn to cement in the toilet water.

But good luck! You'll be fine

 

[xJillx]

Just be prepared clean your toilet out well afterwards. That stuff seems to turn to cement in the toilet water.

Oh man! I have already thoroughly ruined all the toilets in my house due to my purple urine from the mesalamine. Well, really just the one in the master because I don't allow myself to use the other toilets so the deep cleaning is limited to only one. But thanks for the warning! By the way, do you know if the barium for the lower bowel series is similar to the one used for a CAT scan? I hope so, because that stuff was easy to get down.

 

[Misty-Eyed]

Haha no problems. Never heard of purple urine from mesalamine, though! Can't say I've ever experienced it.

Hmm never had a CAT scan, so I'm not sure. I had no problems drinking it though and I was only about 12/13 at the time. I'd drink it over prep ANYDAY.

 

[moogie]

I'm happy you don't have to go through the eneema. I had it when I was thirteen and I lost concouisness,

Good luck to you. Drinking Barium is better than before they actually have flavors now

Hope it turns out ok.

 

[tummygirl]

The stuff you drink for a catscan is sort of a funny tasting water; where as the stuff you drink for a small bowel follow-through (barium swallow) is more like a thick milkshake.

They didn't have flavours at my hospital! But it didn't have any flavour really. It was just super thick, so you have to keep stirring it.

 

[dreamintwilight]

I didn't think the barium was too bad either. Tasted like strawberries. But I was super thirsty too!

Definitely drink tons of water. I thought I was doing a good job of drinking water, but it took 3-4 days for everything to finally clear. And I had to flush the toilet like 3 times before it would flush down. Haha. So weird.

 

[StarGirrrrl]

Just had one of those yesterday! I didn't get any flavours and they had watered it down before I got there so not too bad. Have to drink it up quickly which is the hardest part, a bit queasy once it hit but once it had been absorbed it was fine.

 

[lorraine]

To me, the contrast for CT scan and my small bowel series tasted identical and had identical textures. Not a huge fan in either case, but it's tolerable.

 

[StarGirrrrl]

Yep I have now discovered you will have to be very pro-active with toilet flushing and scrubbing with the brush for a couple of days! lol.

 

[xJillx]

Yep I have now discovered you will have to be very pro-active with toilet flushing and scrubbing with the brush for a couple of days! lol.

Thanks for the heads up! I will stock up on Scrubbing Bubbles Toilet Gels. Have you tried them - they are amazing! It's a gel you put in the toilet to self clean each time you flush and it actually works. I bought them because my urine stains all of our toilets due to the masalamine. (However, I am one of the few that have seemed to have this complaint with masalamine on the forum and I am wondering if this side effect is uncommon and serious because I now have a UTI/possible kidney infection. But that is another issue...)

 

[StarGirrrrl]

Haven't heard of those no, but not sure they will work in this instance. Barium is not water soluable, it kind of sits there and can get compacted into lumps so you're best off with a brush to loosen it and then flush, flush, flush!

 

[xJillx]

Well, I had the test yesterday. The barium wasn't the best, but certainly not an issue compared to prep. But, boy, it took all day for it to work itself through my system. I was taking x-rays off and on for about 4 hours! My GI hasn't reviewed them yet, but the doc supervising said everything seemed normal, however, he wasn't able to get a good look at the colon because my small intestine was in the way; he tried moving me in all different positions and pushed on my stomach to shift things around without much luck. But the real purpose of the test was to see if my small intestine was affected, and it didn't seem to be. So, that is good news. I just wish he was able to see my colon better. I'll be eager to hear from my GI. Oh, and no real issue with passing the barium. I mean, my stools are a weird color, but that is it really.

 

[BLM]

Hey Jill, glad everything worked out for you....I hope you get some answers. Keep us posted.

 

[xJillx]

Yep I have now discovered you will have to be very pro-active with toilet flushing and scrubbing with the brush for a couple of days! lol.

StarGirrrrl, How long did it take for you to completely be rid of the barium? I am still passing it through my BM's after 3 days.

 

[dreamintwilight]

That's about how long it took for me, Jill. About 3-4 days.

 

[xJillx]

Thanks, Marisa!

 

[sawdust]

Great news, Jill! I have also had this test to see the extent that my small intestine is involved. The best results I seem to get, though, are from a colonoscopy because of where my Crohn's is located.

This is a pretty gross story, so please skip it, if you'd rather not read nastiness.

I was going to tell you this story when you first opened this post, but decided to save the details until you were finished. Everyone seemed to have you covered on the important things.

When I was yet to be diagnosed and had my barium follow through (at Abington, which you probably know where that is), I had spent days up to my test vomiting anything I ate. I didn't know what to expect, but when I showed up for my test, they shoved two cups into my hands and told me to drink them down as quickly as I could.

Well, it goes without saying that the taste is less than desirable, but whatever inflammation was causing my troubles was starting to gurgle as I drank that stuff. I started to sweat and feel faint and I just knew I was going to chuck it. The nurse popped in to take the cups from me and saw that I had just downed only half of one of cups so far, so I used the opportunity to ask "what happens if I vomit?" She replied, "don't do that if you can help it... you'd have to start all over." I think she thought I just didn't like the taste of it.

Defeated and frightened that I was entering a perpetual loop of tossing that nasty thick stuff, I renewed my efforts to get this over with. I had one cup finished and was half way through the second, when it hit me. I caught the vomit in my cheeks, hands clamped tightly over my mouth and white barium solution spewing out my nostrils. I looked up and the nurse was standing in the doorway long enough to see me (re)swallow all the second-hand barium in my cheeks and she promptly walked over and took the remaining cup from me.

I know that's terribly disgusting, but I've always wondered what kind of stories are told there about it. She didn't think I just disliked the taste after that though... I'm sure of that! I've had to drink it a number of times since, with no problems, knock on wood.

 

[xJillx]

Great news, Jill! I have also had this test to see the extent that my small intestine is involved. The best results I seem to get, though, are from a colonoscopy because of where my Crohn's is located.

This is a pretty gross story, so please skip it, if you'd rather not read nastiness.

I was going to tell you this story when you first opened this post, but decided to save the details until you were finished. Everyone seemed to have you covered on the important things.

When I was yet to be diagnosed and had my barium follow through (at Abington, which you probably know where that is), I had spent days up to my test vomiting anything I ate. I didn't know what to expect, but when I showed up for my test, they shoved two cups into my hands and told me to drink them down as quickly as I could.

Well, it goes without saying that the taste is less than desirable, but whatever inflammation was causing my troubles was starting to gurgle as I drank that stuff. I started to sweat and feel faint and I just knew I was going to chuck it. The nurse popped in to take the cups from me and saw that I had just downed only half of one of cups so far, so I used the opportunity to ask "what happens if I vomit?" She replied, "don't do that if you can help it... you'd have to start all over." I think she thought I just didn't like the taste of it.

Defeated and frightened that I was entering a perpetual loop of tossing that nasty thick stuff, I renewed my efforts to get this over with. I had one cup finished and was half way through the second, when it hit me. I caught the vomit in my cheeks, hands clamped tightly over my mouth and white barium solution spewing out my nostrils. I looked up and the nurse was standing in the doorway long enough to see me (re)swallow all the second-hand barium in my cheeks and she promptly walked over and took the remaining cup from me.

I know that's terribly disgusting, but I've always wondered what kind of stories are told there about it. She didn't think I just disliked the taste after that though... I'm sure of that! I've had to drink it a number of times since, with no problems, knock on wood.

You poor thing! Yeah, the nurses aren't always understanding. I took some time to get the two cups down (about 15 mins.) and I know they were not happy with my timeline. I felt like saying, "Why don't you try to suck this crap down!" But let me tell you, I'd take the barium any day over prep. I think about that nasty stuff and I shutter!

 

[StarGirrrrl]

That's about how long it took for me, Jill. About 3-4 days.

Ditto!