Barium Sulfate

Indications

Barium Suphate is used to help doctors examine the esophagus (tube that connect mouth and stomach), stomach and intestine using X-rays or computed tomography (CAT scan, CT Scan; a type of body scan that uses a computer to put together X-ray images to create cross sectional or three dimensional picture of the inside of the body). Barium sulphate is a class of medications called radiopaque contrast media. Its works by coating the esophagus, stomach or intestine with a material that is not absorbed into the body so that diseased or damaged areas can be clearly seen by X-ray examination or CT scan.

Pharmacology

Barium sulfate increases the absorption of x-rays as they pass through the body, thus delineating body structures, in which barium sulfate is localized. Barium sulfate is an insoluble material which, because of its density, provides a positive contrast during x-ray examination. Barium sulfate is an inert radiopaque material which is not absorbed or metabolized and is eliminated intact from the body in a manner similar to other non-absorbed inorganic materials. Excretion rate is a function of gastrointestinal transit time.

Dosage & Administration

Barium Sulphate comes as a powder to be mixed with water, a suspension (liquid), a paste, and a tablet. The powder and water mixture and the suspension may be taken by mouth or may be given as an enema (liquid that is instilled into the rectum), and the paste and tablet are taken by mouth. Barium Sulphate is usually taken one or more times before an X-ray examinations or CT scan. If you are using a Barium Sulphate enema, the enema will be administered by medical staff at the testing center. If you are taking Barium Sulphate by mouth, you may be given the medication after you arrive at the testing center or you may be given the medication to take at home at specific times the night before and/or the day of your test. If you are taking Barium Sulphate at home, take it exactly as directed. Do not take more or less of it or take it more often or at different times than directed. Shake the liquid well before each use to mix the medication evenly. If you are given a powder to mix with water and take at home, be sure that you are also given directions for mixing and that you understand these directions. Ask your doctor or staff at testing center if you have any questions about mixing your medications. You will be given specific directions to follow before and after your test. You may be told to drink only clear liquid after a certain time the day before your test, not to eat or drink after a specific time, and/or to use laxatives or enemas before your test. You may also be told to use laxatives to clear the Barium Sulphate from your body after your test. Be sure that your understand these directions and follow them carefully. Ask your doctor or the staff at the testing center if you are not given directions or if you have questions about.
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Contraindications

Barium sulfate products are contraindicated in patients with known or suspected obstruction of the colon, known or suspected gastrointestinal tract perforation, suspected tracheoesophageal fistula, obstructing lesions of the small intestine, pyloric stenosis or known hypersensitivity to barium sulfate formulations.

Side Effects

Common side effects are: severe stomach pain, severe cramping, diarrhea, or constipation, sweating, ringing in your ears, confusion, fast heart rate, pale skin, weakness

Pregnancy & Lactation

Safe use of barium sulfate during pregnancy has not been established. Barium sulfate should be used in pregnant women only if the possible benefits outweigh the potential risks. Radiation is known to cause harm to the unborn fetus exposed in utero.

Precautions & Warnings

General:  Diagnostic procedures which involve the use of radiopaque contrast agents should be carried out under the direction of personnel with the requisite training and with a thorough knowledge of the particular procedure to be performed. A history of bronchial asthma, atopy, as evidenced by hay fever and eczema, a family history of allergy, or a previous reaction to a contrast agent warrant special attention. Caution should be exercised with the use of radiopaque media in severely debilitated patients and in those with marked hypertension or advanced cardiac disease.

Anaphylactic and allergic reactions have been reported during double contrast examinations in which glucagon has been used.

Ingestion of barium sulfate suspension is not recommended in patients with a history of food aspiration. If barium sulfate suspension is aspirated into the larynx, further administration of the suspension should be immediately discontinued.

Patient preparation for diagnostic gastrointestinal examinations frequently requires cathartics and a liquid diet. The various preparations can result in water loss for the patient. Patients should be rehydrated quickly following a barium sulfate suspension examination of the gastrointestinal tract.

Pregnancy: Safe use of barium sulfate during pregnancy has not been established. Barium sulfate should be used in pregnant women only if the possible benefits outweigh the potential risks. Elective radiography of the abdomen is considered to be contraindicated during pregnancy due to the risk to the fetus from radiation exposure. Radiation is known to cause harm to the unborn fetus exposed in utero.

Use in Special Populations

Pediatrics: Two deaths of infants from barium aspiration have been reported; however, the volume of aspirated material rather than the nature of the material was probably the responsible factor.

Geriatrics: Diagnostic studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of barium sulfate in the elderly. However, colon distention has caused electrocardiographic changes, especially in geriatric patients with a history of cardiac disease.

Overdose Effects

In rare instances, immediate repeat oral examinations may lead to severe stomach cramps and diarrhea. Cases reported implicate a total dose in the range of 30 ounces (900 mL) of a 115% w/v barium sulfate suspension. Instances of this type have resolved spontaneously and they are not considered to be life-threatening.

Therapeutic Class

Contrast medium for diagnostic procedures

Storage Conditions

Store at 25° C

Available Brand Names