THE ROLE OF CARBON-DIOXIDE AND ATMOSPHERIC AIR IN DOUBLE-CONTRAST BARIUM ENEMA

Background: Patient discomfort 0-24 h after double-contrast barium ene ma (DCBE) was investigated in two ways. Methods: In part 1, 139 patien ts, not previously informed, were contacted by telephone to assess sym ptom rates without bias. In part 2, designed as a prospective randomiz ed double-blind trial, the effect of carbon dioxide (CO2) as an insuff lating gas was compared with conventional atmospheric air (AA). Result s: Part 1: 10% experienced severe abdominal pain, and 18% severe abdom inal distention. Part 2: Low discomfort rates were found for both seve re pain (7% for AA vs. 2% for CO2) and severe distention (13% for AA v s. 8% for CO2); the differences were not significant. In both parts of the study, female patients with a history of abdominal discomfort of ''colon irritable'' type were significantly overrepresented in the sev erely symptomatic groups. Equal numbers of patients experiencing sever e abdominal distention for the first time were found in both the AA an d CO2 groups, ruling out AA as the sole cause of these symptoms. Concl usion: Abdominal post-DCBE discomfort seems to be less frequent than p reviously reported and is not effectively eliminated by CO2. We still find the use of AA in DCBEs justified.