Small Bowel What?

It's a small bowel follow through. That's what I'm having on the 20th and it includes barium. I told ya'll it would, don't look surprised. I cut and pasted some information for ya'll to read, you know, just can case your stomach ever falls through your butt or something thereabouts. As for the perforation thing, I can guarantee you, that I indeed do not shove freshly sharpened pencils up my ass! This is going to be a fun test. Adios dignity.

A Small Bowel Follow Through (SBFT for short) is, as the name implies, an exam that follows barium (a thick, chalky fluid) or some other contrast media through the small intestines. For those who are interested, the small bowel, or intestine, is a thin hollow tube like organ measuring approximately 22 feet in length in the average adult, with a diameter of about 1 to 1 ½ inches. The first 8 to 10 inches of the small intestine is relatively fixed in position, and is referred to as the Duodenum. The other two sections, the jejunum and the ileum, form a series of freely moving loops attached to the back wall of the abdomen. As you would imagine, it can easily take two or three hours from the time the study starts until the first traces of barium can be seen emptying out of the small intestine into the large intestine under x-ray.

Since the Large Intestine, or Colon, loops around and in front of the Small Intestine, it is necessary to start preparing for this exam the day before to insure that the Small Bowel and the Colon are as empty of solid material as possible. This preparation normal consists of laxatives and a low-residue diet, which is made up of foods that leave little to no waste behind for the body to expel. For an example of such a diet, please see the Barium Enema page on this site. On the morning of your exam, you may not eat or drink anything until your exam is completed.

When you check in for your exam, the technologist who will be in charge of doing your study will show you to a dressing room where you will be asked to strip down to your underpants (sorry ladies, but bras sometimes show up in the middle of this exam) and put on a hospital gown. You will then be escorted to the x-ray room where your study will be performed. Once in the room, an x-ray called a "Scout Film" will often be done to be sure that there are no unexpected surprises lurking that may cause problems. You will then be given two cups of a thick, white, chalky fluid called Barium to drink. The technologist will then lay you down, and an x-ray will be taken at once, followed by another picture every 15 to 30 minutes until the barium starts to empty out of the Small Intestine and into the Large at the junction of those two organs and the appendix. Once that point in the exam has been reached, the Radiologist (a medical doctor who specializes in x-ray) will come in and take several more films under fluoro (short for fluoroscopy) which can be likened to Radiology's version of the camcorder. Once the radiologist has finished with what he or she needs to see under fluoro, you will probably be free to leave.

Occasionally, your doctor may suspect a condition such as a perforation or a complete obstruction of the small intestine, or possibly some other problem that may require surgery on short notice. In these case, your exam will probably be done using a "water soluble" contrast medium. This is done for two reasons. One, a water soluble contrast media, such as Gastografin, will be absorbed by the body over a relatively short period of time and eliminated through the kidneys. Barium on the other hand can only be quickly and effectively eliminated by the body by passing through to the other end. Thus, if for some reason the contrast medium leaks out of the intestines and into the abdominal cavity, a water soluble contrast will not cause potentially dangerous complications the way barium might. The second reason is that since water soluble contrast media is much thinner than barium, it is much easier to suck back out if need be than barium is. There is a major draw back to water soluble contrast mediums though. Since the small intestine works by mixing whatever is in it with water and digestive fluids, then absorbing what it can, water soluble contrasts will become more dilute and harder to see on x-rays as time passes. Barium however does not mix well with these fluids produced in the small intestines, so it will remain highly visible on x-rays no matter how much time passes. Because of this, if you have your study done using Gastografin or similar water soluble contrast mediums and the radiologist overseeing your study cannot find a problem, you will often be asked to come back at a later date to have the study done using barium.

After you leave the facility at which you have had your study, it is highly recommended that you drink plenty of water that day and the next. This will help the barium pass smoothly through your body. Your stools for the next day or so may be a whitish gray in color however. This is nothing to worry about, and once the barium has been completely passed, your stools will return to their normal coloring and consistency.