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November 1990

Inadequate Barium Enemas in Elderly Patients

Author Affiliations

Winston-Salem, NC

Arch Intern Med. 1990;150(11):2412. doi:10.1001/archinte.1990.00390220140036

To the Editor.—We read with interest the article by Tinetti et al1 on inadequate barium enemas in hospitalized elderly patients that appeared in the September 1989 issue of the Archives, and would like to comment on their findings. Radiographic examination of the colon is often difficult in these patients because of inadequate cleansing of the bowel and inability of the patient to cooperate due to poor retention or physical impairment. More vigorous bowel preparation and the use of cleansing enemas, along with the careful insertion of ballontype rectal tips, if needed, improve results.2 Also, based on the age and physical condition of the patient, we generally prefer performing a singlecontrast barium enema in the elderly.3 The double-contrast examination requires good cooperation and mobility from the patient to achieve the best outcome.

The single-contrast barium examination can provide excellent results even if patients are not fully cooperative