Can I Schedule a Pain-Free Colonoscopy After Barium Enema?

Colonoscopy

Dear Director Ke,
After cleansing the intestines, is it possible to first arrange for a painless colonoscopy under anesthesia, and then proceed with a barium enema? (Due to right lower abdominal pain and a constant sensation of incomplete evacuation, the outpatient physician at Tzu Chi Taichung arranged for a barium enema.
Since the intestines are already cleansed, I would like to self-pay for a painless colonoscopy.) I would like to know if this is feasible or if there are any risks to consider.
Two years ago, I underwent a colonoscopy, which did not reveal any polyps, but I have four internal hemorrhoids.
Two months ago, I had a ligation procedure for one of the internal hemorrhoids, but the sensation of incomplete evacuation and abdominal pain has not improved at all.
Could you please advise if there are any side effects from the ligation of internal hemorrhoids? Would I need to have the remaining three ligated to have a chance of resolving the sensation of incomplete evacuation?
Thank you for taking the time to respond!

Miya, 40~49 year old female. Ask Date: 2021/01/24

Dr. Ke Fangxu reply Surgery

Since a colonoscopy has been performed, there is no point in doing a barium study.
The reason the physician arranged for a barium study is likely because a colonoscopy was done two years ago.
In fact, the accuracy of a colonoscopy is higher than that of a barium study, and patients under 50 do not need to undergo these examinations so frequently.
The purpose of hemorrhoid ligation is to stop bleeding or treat prolapse, and it is unrelated to the sensation of incomplete evacuation or abdominal pain.
There should be no long-term complications such as pain or bleeding; however, complications can occur.
Therefore, undergoing ligation again will not improve your sensation of incomplete evacuation.

Reply Date: 2021/01/24

More Info

When considering scheduling a pain-free colonoscopy after a barium enema, there are several factors to take into account. First, it’s essential to understand the procedures involved and the potential implications of undergoing them in close succession.

A barium enema is a diagnostic procedure that involves filling the colon with a barium solution to enhance imaging for X-rays. This procedure can sometimes cause temporary discomfort or cramping, and it may take some time for the barium to clear from your system. After a barium enema, it is generally recommended to allow your body some time to recover before undergoing another invasive procedure like a colonoscopy. This is primarily to ensure that your colon is adequately prepared and free of any residual barium, which could interfere with the colonoscopy results.

Regarding the safety of scheduling a pain-free colonoscopy immediately after a barium enema, it is crucial to consult with your healthcare provider. They will assess your specific situation, including your medical history, the reason for the colonoscopy, and any symptoms you are experiencing, such as your ongoing abdominal pain and sensation of residual stool. They may recommend a waiting period to ensure that your colon is fully cleared and that any potential irritation from the barium has subsided.

As for your previous colonoscopy, where no polyps were found, and your recent hemorrhoid ligation, it’s important to note that while hemorrhoid treatment can alleviate certain symptoms, it may not completely resolve feelings of incomplete evacuation or abdominal discomfort. If you are still experiencing these symptoms, it may be worthwhile to discuss them further with your physician. They can evaluate whether additional treatments for your hemorrhoids are necessary or if other underlying conditions might be contributing to your discomfort.

In summary, while it may be technically possible to schedule a pain-free colonoscopy after a barium enema, it is essential to consider the timing and your overall health status. Consulting with your healthcare provider will provide you with the best guidance tailored to your specific needs. They can help determine the safest and most effective approach to manage your symptoms and ensure that any necessary diagnostic procedures are performed in the most appropriate sequence.

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