Barium sulfate suspension is an inert, insoluble material used as a contrast agent. This radiopaque material works by coating the inner lining of the esophagus, stomach and intestines to allow health care providers to see these structures more clearly on radiologic examination such as x-ray or computed tomography. This helps diagnose certain disorders in the gastrointestinal tract. Barium sulfate is neither absorbed nor metabolized, but is eliminated from the body at a rate dependent on gastrointestinal transit time.

Dosage of Barium Sulfate Suspension

The dose of barium sulfate will be various for different people. Use this only as prescribed by your doctor. It may be taken by mouth or used as a rectal enema. Follow the doctor's instructions about using the formula. Barium sulfate suspensionis available as aready-to-use medication or as a powder that needs to be dissolved in water. When placed in water, stir thoroughly into a mixture and drink the entire dose right away. Dosage may vary:

• For upper GI opacification: you may be asked to drink about 250 mL of the suspension approximately 30-60 minutes before CT scan. You may be asked to take an additional 200-250 mL of the suspension around 5-10 minutes before the examination. For more rapid upper GI transit, take barium sulfate suspension chilled.
• For total bowel opacification: you may be asked to drink 250-500 mL of the suspension about 1-2 hours before CT scan and another 250-500 mL around 5-10 minutes before theexamination.
• Sometimes, the radiologist may instruct you to take 250-500 mL of barium sulfate on the evening before your examination.If given the night before scanning, a lower concentration may be used, especially in infants, because of lower body fat content.
• For rectal administration, it is administered at room temperature through an enema administration unit kit. You will receive it at the hospital or clinic where testing will be done.

Side Effects of Barium Sulfate Suspension

Common side effects include:

• Nausea, vomiting
• Stomach cramps
• Loose stools
• Mild constipation

Severe reactions due to barium sulfate are infrequent (1 in 500,000) and deaths are rare (1 in 2,000,000). Complications related to the procedure using contrast agents like barium sulfate are rare. These may include:

• EKG changes
• aspiration pneumonitis
• impactionofbarium sulfate
• granuloma formation
• embolization
• intravasation
• intestinal perforation and peritonitis
• septicemia
• vasovagal/syncopal episodes

Allergic reactions may occur in atopic patients, so if you have a history of any allergies and allergic-like symptoms like rhinitis, asthma and eczema, tell your doctor before undergoing any medical procedure.

Call your doctor if you experience:

• Sweating
• Confusion
• Weakness
• Rapid heart rate
• Severe stomach pains
• Severe diarrhea, cramping, or constipation
• Ringing in ears
• Pale skin

Precautions for Barium Sulfate Suspension

Diagnostic procedures that involve the use of barium sulfate should be done under the supervision of trained personnel with thorough knowledge of the procedures to be performed. Special attention must be given to patients who have a history of asthma, atopy, eczema, allergies, or a previous allergic reaction to contrast agents. Caution must be exercised when using radiopaque agents in patients with marked high blood pressure, advanced heart disease, and those who are severely debilitated.

Babies with intussusception have an increased risk of intestinal perforation. Babies who have Hirschsprung’s Disease have a risk of retaining large amounts of the suspension, which may result in fluid overload.Patients with cystic fibrosis or ileus have a greater risk of partial or complete intestinal obstruction.

1. When to Avoid Barium Sulfate Suspension

Barium sulfate should not be used in patients known to have known hypersensitivity to the drug and in those suspected to have gastrointestinal tract perforation. Ingestion of the suspension is not advisable in patients who have a history of food aspiration.

The safety of use of barium sulfate suspension during pregnancy is unknown. Therefore it should be used in pregnant patients only if the benefits outweigh its potential risks. Elective radiographic procedures of the abdomen are contraindicated during pregnancy because of the potential risk to the fetus. In utero, exposure to radiation is known to cause harmful effects to the fetus.

2. Allergic Reactions

Mild allergic reactions are rare and these include generalized erythema, pruritus, or urticaria. These reactions often improve with an antihistamine. Serious reactions are even more uncommon and may result in bronchospasm, edema of the larynx, or hypotension.

Emergency treatment should be done when these signs and symptoms occur:

• Agitation
• Confusion
• Skin turning blue
• Drop in blood pressure
• Rapid heart rate
• Difficulty breathing
• Bronchospasm
• Unconsciousness

Allergic reactions related to the procedure, such as use of latex gloves or retention catheters with latex material, can also occur. These reactions may occur immediately and lead to acute or delayed responses like contact dermatitis.