What Is a Double Contrast Barium Enema (DCBE)?

Screening for Colon Cancer With a Double Contrast Barium Enema

Colon. Wikimedia Commons

A double contrast barium enema (DCBE) is a screening test used to help diagnose colon cancer and other bowel abnormalities. If your doctor sees something suspicious during a DCBE, he or she may order a follow-up colon cancer screening test such as a colonoscopy or flexible sigmoidoscopy.

The abnormalities seen during a DCBE may be polyps or adenomas, growths in the colon that if left untreated, may turn into colon cancer.

However, some abnormalities seen during a DCBE can signal colon cancer itself.

How to Prepare for a Double Contrast Barium Enema 

To prepare for a DCBE, your doctor or nurse will give you instructions for the day or two before. This will involve taking laxatives or other medications, and possibly a special diet to cleanse stool out of your colon so your doctor can see everything clearly during the test.

Your doctor or nurse also may provide you with instructions for performing an enema at home before the test as another way to make sure your colon is clear of stool.

How Not to Dread Colon Cancer Screening provides detailed information on how to get ready for this test, along with tips for making this preparation easier.

What Happens During the Test?

The double contrast barium enema (DCBE) is a type of x-ray. During the test, which takes about 30-45 minutes, you will not be sedated. If you are worried about this, talk to your doctor about other tests that may work better for you and during which you can be sedated.

During the test, you will lie on a table and your doctor will use a small tube inserted into your rectum to partially fill your colon with barium sulfate. Barium sulfate is a white, chalky liquid that helps the doctor see the outline of your colon on an x-ray.

After the barium is placed into your colon, your doctor will add air, to improve the view on the x-ray and help with detection of abnormal growths.

Your doctor will take x-rays from several different angles to see your whole colon. Your doctor may ask you to move around on the table and turn over to help spread the barium sulfate through your colon and provide additional views. You may feel the need to have a bowel movement, and immediately after the test you will be able to use the bathroom to allow the barium sulfate and air to leave your body.

If your doctor sees any suspicious growths or areas on your DCBE test, you likely will need a sigmoidoscopy or colonoscopy to follow up.

What Are Possible Complications of DCBE?

You may have cramping after the test and you will need to go to the bathroom to empty your bowels immediately after the test is done.

Barium sulfate may cause constipation for a few days after your test, and your stools will appear chalky, grey, or white until the barium is out of your system.

There is a small risk of colon puncture during the DCBE test, but this risk is extremely small and much less than the risk associated with a colonoscopy.


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The National Cancer Institute: Colon and Rectal Cancer. Accessed: January 15, 2009.

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