SEW Ue MR en min nse ES Barium Meal Follow Through (BMFT) _ It is the Radiographic examination of small bowel till ileocecal junction. Barium meal follow through is performed to diagnose structural or functional abnormalities of the small intestine by using the barium sulfate contrast Media. It may be performed as a Separate or continuous with the upper gastrointestinal study, The barium meal follow through examination may be performed by two methods- A. Single contrast study- evaluate small intestine disorders and abnormality B. Double contrast study- evaluate the mucosal details 5S Anatomy- The small intestine is 20 feet long, it divided into the 3 parts 1, duedenum- it is the shortest part of the small intestine connect with stomach,2 jejunum-it connects the duodenum to the ileum, and 3, ileum- it connects the cecum at the ieocecal junction. The ileum is the longest part it absorbs water and nutrients from food through villi. 1 Indication- ¢ Crohn’s disease (Inflammatory bowel disease) ¢ Abdominal pain © Diarrhea° Loss of weight © Gastrointestinal bleeding ¢ Partial obstruction e Diverticulosis * Malabsorption ¢ Suspected mass and lesions Contraindication- © Paralytic ileus e Recent GL. surgery ¢ Tracheo-oesophageal fistula © Suspected perforation e Suspected pregnancy « Complete bowel obstruction If perforation and fistula are suspected o7 + where barium is contraindicated, nonionic water-soluble iodinated contrast media is used to perform the examination. Equipment- ¢ Fluoroscopic unit with Tilting table attached image intensifier or spot film device/ high-speed cassettes. Medium density of Barium sulfate suspension. Effervescent powder (gas producing agent) for double contrast study Patient Preparation- ¢ Ask the patient to take a low residue diet for two days prior to the examination _ e A laxative may be given to the patient, the night before the examination. e Instruct the patient, not to smoke or chew gum because it prevents proper coating of Barium sulfate on the mucosa. « Fasting may be employed for 6 hours. Ask the patient not to eat or drink after midnight.hrough (BM! Procedure- ° On the day of examination describe the whole procedure to the patient. ¢ Technologist should obtain consent from the patient for permission of Procedure, ° Ask the patient to remove clothing and wear a hospital gown. » Single contrast study- 1. Place the patient in the up supine position on the fluoroscopic table, and then take a scout film of the abdomen to see the bowel preparation. If the residual fecal matter is present in the bowel, the examination should be Postponed for the next day. 2. The patient is instructed to take 150 ml Barium sulfate suspension. The radiologist evaluates esophagus and the stomach under fluoroscopy. After the evaluation, the patient is asked to drink medium density 400 ml Barium sulfate rapidly then turn the patient in right side down position for gastric emptying for 15 minutes. 3. After the gastric emptying, place the patient in the prone position to separate the bowel loops. The radiologist observes the flow of Barium sulfate in The Jejunum and proximal ileum under fluoroscopy. When the barium is filled in jejunum and proximal ilium, spot film of jejunum and proximal ileum is taken. The radiologist should monitor the flow of barium sulfate in every 30 minutes until the barium reach at the terminal ileum. When barium is visualized in terminal ileum place the patient in Supine position then turns the patient’s right side slightly up and spot film is taken of ileocecal Junction. 4, When barium reaches in caecum or in ascending colon, the full-length radiograph of the abdomen is taken in AP projection, e Additional films- J. To demonstrate diverticula erect films of the abdomen is taken. 2. To separate bowel loops -if bowel loops are overlapping, place the patient in prone position apply compression on abdomen and radiograph 1s takenDouble contrast study- It may be performed as continuous with Single contrast study. When the barium reached caecum effervescent powder is given to the patient then turn the patient in Lefi lateral position so the gas leaves the stomach and Enter into the small bowel. The radiologist observes the flow of gas under fluoroscopy. Spot film of the small bowel is taken in various positions like oblique. prone and supine. 5 Aftercare- * Patients will be allowed to leave the examination room after the complete examination ¢ Ask the patient to increase fluid intake to avoid constipation Inform the patient about feces will be whitish for two days.