Fluoroscopy Small Bowel Series Quick Reference Guide for Physicians

A Small Bowel Series is an exam that follows barium (a thick, chalky fluid) or some other contrast media through the small intestines. This exam is used to diagnose conditions of the small bowel including Crohn’s disease, ulcerative colitis and bowel cancer.

Counterindications

Known or suspected perforation of the GI tract, bowel obstruction, severe constipation, pregnancy

Patient Preparation

Fast for at least 8 hours. Nothing by mouth including smoking or chewing gum after midnight the day before the exam.

CPT Codes

• 74250
• 74245 (single contrast UGI with SB)

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General Information

What is a small bowel series?

A small bowel series is an x-ray examination of the small bowel using fluoroscopy and an orally ingested contrast material called barium. Fluoroscopy makes it possible to see internal organs in motion. When coated with barium, the radiologist is able to view and assess the anatomy and function of the small bowel.

Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant.

Your patient may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, dentures, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

How is the procedure performed?

After the patient drinks the liquid barium, which resembles a light-colored milkshake, xray images of the abdomen will be taken at certain intervals until the barium has reached the colon. The time it takes for the barium to reach the colon varies among people. Usually it takes about 1 hour, but can vary from 15 minutes to 5 hours. Once the barium reaches the colon, the radiologist will use the fluoroscope to look at the motion of the small bowel

What will my patient experience during and after the procedure?

After the examination, your patient can resume a regular diet and take orally administered medications. The barium may color your patient’s stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. If your patient is unable to have a bowel movement or if your bowel habits undergo any significant changes following the exam, he/she should call you.