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During the barium enema procedure, the contrast material may perforate the colon and spill into the abdominal cavity. The lining of the abdominal cavity may become infected (the condition is called chemical peritonitis). The colon may narrow and become blocked.

Because of these possible problems, certain people may not be good candidates for this procedure.

The bowel is prepared before the procedure. Anyone undergoing a barium enema must be monitored during the bowel preparation procedure.

Perforation rates among the different types of enemas are probably due more to perforations that occurred prior to the enema, and the pressure exerted within the colon, rather than from the contrast material used.

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