Bariumexamintions of the small intestine and the colon in inflammatory bowel disease

Purpose. This article gives an overview of the possibilities of conventional radiography in the diagnosis of inflammatory bowel disease of the small intestine and colon. Material and methods. For more than 25 years we examine the small bowel employing enteroclysis with barium and methylcellulose and the colon with the usual double-contrast method. In the last 152 months 1560 small bowel enemas were performed. In the last 40 months 410 examinations of the colon were performed. Results. There is a thirty percent decrease in enteroclysis examinations within the past 5 years, however, the rate of examinations with positive results increased from 46 to 57%. The proportion of the inflammatory small intestinal diseases (not only Crohn's disease) remained constant with 18%. Concerning the examinations of the colon for inflammatory disease we confirmed the diagnosis in seven cases. The radiation exposure for the enteroclysis in inflammatory diseases was 7 mSv, for colon examinations 14 mSv. Conclusion. Barium examinations, especially of the stomach and colon are decreasing in frequency. Therefore the art of performance and interpretation might get lost. Enteroclysis, however, is still the method of reference for the other imaging methods. The advantages compared to the other imaging methods are the excellent presentation of the details of the mucosal surface and the observation of functional disorders.