The role of carbon dioxide and atmospheric air in double-contrast barium enema

Abstract

Background

Patient discomfort 0–24 h after double-contrast barium enema (DCBE) was investigated in two ways.

Methods

In part 1, 139 patients, not previously informed, were contacted by telephone to assess symptom rates without bias. In part 2, designed as a prospective randomized double-blind trial, the effect of carbon dioxide (CO₂) as an insufflating gas was compared with conventional atmospheric air (AA).

Results

Part 1: 10% experienced severe abdominal pain, and 18% severe abdominal distention. Part 2: Low discomfort rates were found for both severe pain (7% for AA vs. 2% for CO₂) and severe distention (13% for AA vs. 8% for CO₂); the differences were not significant. In both parts of the study, female patients with a history of abdominal discomfort of “colon irritabile” type were significantly overrepresented in the severely symptomatic groups. Equal numbers of patients experiencing severe abdominal distention for the first time were found in both the AA and CO₂ groups, ruling out AA as the sole cause of these symptoms.

Conclusion

Abdominal post-DCBE discomfort seems to be less frequent than previously reported and is not effectively eliminated by CO₂. We still find the use of AA in DCBEs justified.