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July 4, 1977

Preparation for Barium Enema

JAMA. 1977;238(1):27. doi:10.1001/jama.1977.03280010027007

To the Editor.—  The overall diagnostic quality of barium enema roentgenograms is quite poor. We are missing 35% to 60% of notable pathologic findings; most of these findings would be readily demonstrable with good-quality roentgenograms.At least two areas must be addressed.

  1. I will dispense with the part about which we can do little, and that is the radiologist, both regarding the care with which the examination is done and the technique used. A difference of opinion exists as to the relative efficacy of air-contrast vis-à-vis high-voltage techniques or both, depending on the reason for the study.

  2. That which we can influence considerably is the patient bowel preparation. Excellent or good patient preparation may be predictably, rather simply, and realistically obtained in 96.7%.2

Patients will comply with intelligent instructions. Both verbal and supplemental written well-thoughtout and clearly presented instructions are necessary. It is suggested that the most interested