small-bowel follow through

Last reviewed 01/2018

• radiographic examinations of the small bowel are known as barium follow-through examinations (small bowel follow through)
  • this contrast examination involves the patient drinking a quantity of barium and then radiographic imaging of the passage of barium through the small bowel. The examination is made up of a series of radiographic images (approximately every 20-30 minutes) and the total examination usually takes 2-3 hours (but can take longer)
• this examination should allow identification of structures of the small bowel
  • the duodenum, jejunum and ileum
  • the jejunum internal surface is characterised by the presence of the numerous plicae circulares (or valvulae coniventes) which can be visualised via this examination
    • radiological differences between the jejunum and ileum amount to a gradual decrease in size of the lumen as the caecum is approached and changes in the mucosal pattern. The mucosal pattern appears smoother and less feathery in the ileum when compared to the jejunum
  • possible indications for a small-bowel follow through include:
    • unexplained abdominal pain
    • suspected Crohn's disease
    • suspected intermittent partial small bowel obstruction
    • malabsorptive symptoms e.g. steatorrhoea
    • unexplained gastrointestinal bleed
    • suspected small bowel fistula.
  • small bowel follow-through may reveal evidence of disorders such as Crohn's disease, Coeliac disease or small bowel tumours