Barium enema after flexible sigmoidoscopy: is delay necessary?

Area of Science:

• Gastroenterology
• Radiology

Background:

• A common belief suggests sigmoidoscopy prior to barium enema causes gas and irritability, potentially hindering the barium enema study.
• Physician practices often reflect this belief, with many advising against same-day sequential procedures.

Purpose of the Study:

• To investigate the validity of the traditional belief regarding sigmoidoscopy and barium enema.
• To assess the feasibility and impact of performing flexible sigmoidoscopy immediately before air-contrast barium enema on the same day.

Main Methods:

• A survey of primary care physicians was conducted regarding their community's standard practice.
• A prospective study involved 16 subjects undergoing a 60-cm flexible sigmoidoscopy followed by an air-contrast barium enema.

Main Results:

• Nearly two-thirds of surveyed physicians reported delaying barium enema after sigmoidoscopy as standard practice.
• In the prospective study, 94% (15/16) of subjects completed both radiologic examinations without increased technical difficulty or patient discomfort.
• One subject required rescheduling due to excessive gas.

Conclusions:

• The majority of patients can undergo flexible sigmoidoscopy and barium enema sequentially on the same day.
• Same-day scheduling offers significant savings in time, effort, and patient exposure to bowel preparation protocols for appropriate individuals.