What is the test used for?

A small bowel series is used to look at the small bowel, the part of the digestive tract between the stomach and the colon. A barium compound diluted with water fills the inside of the small bowel, and x-rays are taken. Barium looks white on x-ray, and outlines any irregularity of the bowel wall.

What is the preparation for the test?

The small bowel has to be as clean as possible before the test. If there is a lot of food products in the intestine, the barium won't be able to flow freely, and small pieces of food product left inside the bowel may look like abnormalities.

You will be given a preparation kit to start the day before the test. Follow the instructions with the kit (see sheet). Unfortunately, watery diarrhoea is the desired effect of the preparation.

Will I have to undress?

You will be asked to remove most of your upper clothes, but may keep wearing your underpants. Buttons, clips etc on clothes show up too well on x-ray and can be confusing to interpret or hide abnormalities. You will be asked to change into a cotton gown, opened at the back.

Where will I be for the test?

You will be asked to lie on a fluoroscopy table. This is an unfortunately hard table which can move in many directions as well as tilt.

How is the test done?

Barium liquid is swallowed, and passes from the stomach into the small bowel. The object of the test is to fill the length of the small bowel with barium. This means that several hundred mls of liquid may have to be swallowed. Don't worry - we want you to swallow as much as possible, and won't force you to drink it so fast that you feel sick. After the liquid is drunk, you will be asked to lie on your right side, so the liquid leaves the stomach and passes into the small bowel.

The normal "transit time" through the small bowel is very variable, and may be between 5 minutes and several hours. If you experience pain at any time, tell the doctor. The pain may help to localise areas of disease, so don't hesitate in telling.

Several x-rays will be taken. The doctor may ask you to roll around on the x-ray table to view all the loops of the bowel. The doctor may also press firmly on your tummy to help view the bowel loops. The x-rays are then processed and checked by the doctor, who may need to take some more.

Once the barium is through the small bowel and the pictures are taken, you will be allowed to go to the (nearby) toilet, as the liquid has reached the large bowel. Usually the capacity of the large bowel, and the ability of the large bowel to absorb water mean that diarrhoea is uncommon.

How long will it all take?

The test takes anything from 30 minutes to many hours depending on how fast your intestine can move the liquid through the many metres of small bowel. If the progress is slow, we may ask you to leave the fluoroscopy room and wait for 20 or 30 minutes before checking progress.

And after the test?

The barium looks like cement, but fortunately does not set like cement! Drink plenty of clear fluids over the next day.

Does the test use radiation?

Ionising radiation is used.