Current perspectives in colon radiography: the postendoscopy and postbiopsy barium enema

Controversy prevails regarding the same-day performance of barium enema examinations and endoscopy. Concerns focus upon the diagnostic quality of the postendoscopy barium enema and the risk of perforation if colorectal biopsy is performed during the endoscopy. Results of a study of 295 patients support that rigid or fiberoptic sigmoidoscopy can be performed the same day as single- or double-contrast barium enemas without adversely affecting the quality or interpretation of the barium examination. Animal studies suggest that a barium enema may be performed safely immediately after a superficial biopsy of a nondiseased colon and 6 days after a deep biopsy. Barium sulfate appears to have no deleterious effect on the healing of colorectal biopsy sites. These findings have important implications when considering health care logistics and cost containment.