Glucagon-induced small bowel air reflux: degrading effects on double-contrast colon examination

Glucagon-induced small bowel air reflux and its effect on the diagnostic quality of the double-contrast barium enema examination was prospectively evaluated in 103 patients. These were randomly assigned to receive 0.5 mg intravenous glucagon (50 patients) or to a control group without such medication (53 patients). The group receiving glucagon demonstrated an increased amount of small bowel air and a greater magnitude of change in its volume secondary to reflux, as well as degradation in the quality of barium enema study when compared to the nonglucagon group. No significant improvement in visualization of the appendix after glucagon was observed. We conclude that routine administration of glucagon during double-contrast enema would degrade the quality of examination primarily because it promotes retrograde reflux of air into the small intestine.