Norm of Small Bowel Series
No abnormalities in the small bowel contour, position, or motility.
Usage of Small Bowel Series
Cancer, Crohn's disease, diarrhea, enteritis, hematemesis, Hodgkin's disease, lymphosarcoma, malabsorption syndrome, melena, polyps, ulcers, and weight loss.
Description of Small Bowel Series
Fluoroscopic examination of the small intestine after ingestion of barium sulfate. The barium enters the stomach and empties into the duodenal bulb. Circular folds appear as barium enters the duodenal loop. These folds deepen in the jejunum and then lessen in the ileum. The procedure takes 2–6 hours depending on barium transit time through the small bowel.
Professional Considerations of Small Bowel Series
Consent form NOT required.
Aspiration of contrast material, bowel obstruction, constipation.
Obstruction or perforation of the small intestine because the barium may intensify the obstruction or cause seeping of the barium into the abdominal cavity.
During pregnancy, risks of cumulative radiation exposure to the fetus from this and other previous or future imaging studies must be weighed against the benefits of the procedure. Although formal limits for client exposure are relative to this risk:benefit comparison, the United States Nuclear Regulatory Commission requires that the cumulative dose equivalent to an embryo/ fetus from occupational exposure not exceed 0.5 rem (5 mSv). Radiation dosage to the fetus is proportional to the distance of the anatomy studied from the abdomen and decreases as pregnancy progresses. For pregnant clients, consult the radiologist/ radiology department to obtain estimated fetal radiation exposure from this procedure.
- See Client and Family Teaching.
- Preliminary radiographs are taken in supine, erect, and lateral side positions.
- The client is given 500 mL of flavored but chalky-tasting barium orally.
- Radiographs are taken at 30- to 60-minute intervals with the client in supine, erect, and lateral side positions for 2–6 hours to track the barium passage through the small intestine.
- Encourage fluids (4–6 glasses of water per day for 2 days when not contraindicated) to promote the passage of the barium through the intestines.
- A cathartic may be prescribed to prevent barium impaction.
Client and Family Teaching
- Fast from food and fluids and refrain from smoking from midnight before the test.
- A cathartic may be prescribed to be administered the evening before the test.
- Bring reading material or other diversion to the test because the procedure is lengthy.
- Stool will be barium colored for up to 72 hours.
Factors That Affect Results
- Chronic narcotic use can cause delayed motility.
- Barium enema, gallbladder and biliary system ultrasound, and routine radiography should precede a small bowel series, since retained barium clouds details on the radiographs.