methylcellulose and Crohn-Disease

In the 1980s and 1990s in North America and Europe, air (CO(2)) double-contrast barium enteroclysis took a back seat to biphasic methylcellulose double-contrast enteroclysis in the investigation of small-bowel diseases. The widespread application of capsule endoscopy in the 21st century has identified a number of limitations of radiologic examinations in the investigation of mucosal diseases of the small intestine. Evidence-based studies comparing barium, computed tomographic (CT), and magnetic resonance (MR) enteroclysis have shown that in spite of improvements in small-bowel examination methods using CT and MR, barium examinations remain superior in the depiction of mucosal abnormalities, particularly the apthoid lesions of early Crohn disease. Barium small-bowel examinations have been recommended in the patient with a negative CT or MR enteroclysis study where the pretest probability of Crohn disease is high. A recent prospective comparison of methylcellulose double-contrast barium enteroclysis to capsule endoscopy with review of the literature has shown that air enteroclysis depicts mucosal details better than does methylcellulose double-contrast enteroclysis because of the "washout" effect of methylcellulose on superficial mucosal features. Recent articles have shown that air enteroclysis compares favorably with wireless capsule endoscopy and double-balloon endoscopy in the diagnosis of mucosal abnormalities of the small bowel. This article describes the authors' technique of performing air double-contrast enteroclysis, its clinical indications, and its pitfalls.

Topics: Barium Sulfate; Capsule Endoscopy; Carbon Dioxide; Contrast Media; Crohn Disease; Humans; Intestine, Small; Magnetic Resonance Imaging; Methylcellulose; Tomography, X-Ray Computed

This article gives an overview of the possibilities of conventional radiography in the diagnosis of inflammatory bowel disease of the small intestine and colon.. For more than 25 years we examine the small bowel employing enteroclysis with barium and methylcellulose and the colon with the usual double-contrast method. In the last 152 months 1560 small bowel enemas were performed. In the last 40 months 410 examinations of the colon were performed.. There is a thirty percent decrease in enteroclysis examinations within the past 5 years,however, the rate of examinations with positive results increased from 46 to 57%. The proportion of the inflammatory small intestinal diseases (not only Crohn's disease) remained constant with 18%.Concerning the examinations of the colon for inflammatory disease we confirmed the diagnosis in seven cases. The radiation exposure for the enteroclysis in inflammatory diseases was 7 mSv, for colon examinations 14 mSv.. Barium examinations, especially of the stomach and colon are decreasing in frequency. Therefore the art of performance and interpretation might get lost.Enteroclysis, however, is still the method of reference for the other imaging methods. The advantages compared to the other imaging methods are the excellent presentation of the details of the mucosal surface and the observation of functional disorders.

Topics: Barium Sulfate; Colitis, Ulcerative; Contrast Media; Crohn Disease; Diagnosis, Differential; Enema; Humans; Ileal Diseases; Inflammatory Bowel Diseases; Methylcellulose; Radiography; Time Factors; Tuberculosis, Gastrointestinal

The purpose of this study was to evaluate the diagnostic accuracy of multidetector-CT enteroclysis (MDCT-E) versus barium enteroclysis with methylcellulose (BE) in clinically selected patients with suspected small bowel disease. We prospectively studied 52 patients who underwent unenhanced and contrast-enhanced multidetector CT (16 rows) after administration of 2-2.5 l of methylcellulose by naso-jejunal tube. BE was performed after administration of barium 60% w/v (200-250 ml) and methylcellulose (1-2 l). Patients with radiological signs of Crohn's disease were classified into the following subtypes: active, fibrostenotic, fistulising/perforating, reparative or regenerative subtypes. Twenty-eight patients also underwent endoscopy. The radiological prevalent subtype was the active subtype. The sensitivity, specificity and diagnostic accuracy of MDCT-E versus BE was 83%, 100% and 89%, respectively. BE showed five false negative CT cases due to early Crohn's disease; endoscopy confirmed positive cases of the CT and the BE, but showed one false negative case of the BE. Together, MDCT enteroclysis and BE permitted the diagnosis of Crohn's disease in 30 patients, adhesions in one patient, lymphoma in two patients and carcinoid tumours in two patients. In conclusion, MDCT-E permits good representation of pathological patterns. Early stages of Crohn's disease are better evaluated by BE.

Topics: Adult; Aged; Barium Sulfate; Contrast Media; Crohn Disease; Female; Humans; Intestine, Small; Intubation, Gastrointestinal; Male; Methylcellulose; Middle Aged; Radiographic Image Enhancement; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed

Small bowel enteroclysis (SBE) has been suggested to be superior to the small bowel follow-through (SBFT) for diagnosing the presence and extent of Crohn's disease. The aim was to perform a prospective randomized study at a single university medical center comparing SBE with SBFT in patients with Crohn's disease.. Consecutive patients with known Crohn's disease were randomized to receive either SBE or SBFT as the initial study and had the alternate study performed within 2 weeks.. Twenty-six patients were enrolled. The mean time between studies was 8.7 +/- 0.8 days. Both studies were normal in 7 cases. The SBE was negative in 3 cases with positive findings of Crohn's disease by SBFT. One of these cases was a false-positive SBFT. The SBE and SBFT were both diagnostic of Crohn's disease in 15 cases; in 6 cases there was uniform agreement regarding disease pattern. The SBFT more accurately reported mucosal detail (n = 3) and a greater number of fistulas (n = 2). The SBE missed duodenal disease (n = 4).. In known Crohn's disease, the SBFT is the procedure of choice. It is safer, preferred by patients, and will not miss gastroduodenal disease, and when the result is normal, there is no need to perform SBE.

Topics: Administration, Oral; Adult; Barium Sulfate; Contrast Media; Crohn Disease; Cross-Over Studies; Duodenum; False Positive Reactions; Female; Gastric Mucosa; Humans; Ileum; Intubation, Gastrointestinal; Male; Methylcellulose; Prospective Studies; Radiography; Severity of Illness Index

The image quality of oral small bowel imaging is often poor on account of the small bowel enema. A new contrast medium should increase the image quality due to better compliance of patient because of the better taste of substance. The loading of patient with radiation or time should not increase.. We investigated prospectively 40 patients, randomized in two groups of 20 patients each. Two different substances were used as contrast medium: barium-methylcellulose and Barium-Mucofalk, respectively. The quality of the double contrast, profile of the mucosa, duration of radiation, duration of examination, dose-area product, and taste of the substance were judged for significance.. The taste of the new contrast medium was judged to be better: twice as often as "good" and five times less often as "bad", the difference was not significant due to the small number of patients. There is no significant difference in the other criterias.. Mucofalk is an alternative contrast medium for oral small bowel radiology in cases of difficult placement of the tube for enema. The quality of double contrast and visualization of the profile of mucosa are the same while the taste is better.

Topics: Administration, Oral; Barium Sulfate; Contrast Media; Crohn Disease; Humans; Intestinal Diseases; Intestinal Mucosa; Intestine, Small; Methylcellulose; Prospective Studies; Radiation Dosage; Radiography

To evaluate the usefulness of double contrast small-bowel radiography (SBR) in the preoperative assessment of patients with Crohn's disease (CD).. Thirty-nine consecutive patients who underwent surgery for CD between 2000 and 2004, preceded by a preoperative small-bowel series evaluation, were enrolled in our study. The radiologic findings were compared with the intraoperative findings.. Small-bowel radiography was associated with good specificity and sensitivity for the detection of stenosis. Although its main limitation was a remarkable overestimation of stenosis, the main indications for surgery were always confirmed. Sensitivity and specificity were lower for the detection of internal fistulas and the correlation was significant only for SBR performed within 3 months of the operation; however, the concordance between radiological and operative findings was greater. No correlation was observed for the detection of an abdominal mass.. Small-bowel radiography is still reliable for evaluating stenoses and internal fistulas. However, magnetic resonance imaging or computed tomography is mandatory to evaluate an abdominal mass.

Topics: Adult; Aged; Barium Sulfate; Contrast Media; Crohn Disease; Female; Humans; Intestine, Small; Male; Methylcellulose; Middle Aged; Patient Care Planning; Radiography; Retrospective Studies; Sensitivity and Specificity; Statistics, Nonparametric

This study was done to evaluate the diagnostic role of enteroclysis with multidetector computed tomography (MDCT) and single-detector CT (SDCT) in patients affected by small-bowel Crohn's disease.. Forty-five patients underwent abdominal SDCT (n=20) or 16-row MDCT (n=25) after administration of methylcellulose by nasojejunal tube. Each examination was assessed for small-bowel distension and site and characteristics of the diseased loops. The two CT techniques were then compared. Results were compared with double-contrast enteroclysis performed in all patients and with ileoscopy performed in 28 patients.. In comparison with double-contrast enteroclysis, sensitivity, specificity and diagnostic accuracy were 90%, 71% and 89% for SDCT and 92%, 83% and 90% for MDCT. Ileoscopy confirmed the absence of disease in five patients and the presence of Crohn's disease in 20. Compared with SDCT, MDCT reduced scanning time and respiratory artefacts and permitted better multiplanar reconstructions.. MDCT is superior to SDCT because it allows a better spatial resolution and improves depiction of the pathological patterns of Crohn's disease.

Topics: Adult; Aged; Chi-Square Distribution; Contrast Media; Crohn Disease; Female; Humans; Intestine, Small; Iohexol; Male; Methylcellulose; Middle Aged; Prospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed

Little is known about the accuracy of capsule endoscopy (CE) in evaluation of small-bowel Crohn's disease.. Symptomatic eligible patients had ileocolonoscopy and biopsies from the terminal ileum, followed by small-bowel radiologic studies before CE. Endoscopic, radiologic, CE, and histologic findings were compared. Histology (terminal ileum biopsy specimens or a tissue sample after small-bowel resection) served as a criterion standard.. Fifty-four patients were enrolled; 15 of the 54 patients were excluded from data analysis (critical small-bowel strictures, 14, identified on radiology; incomplete CE, 1). Data were analyzed for 39 patients. All patients had histologic evaluation of the small bowel. Final diagnosis of active small-intestine Crohn's disease was made in 29/39 patients (74.4%). When calculated, CE yielded a sensitivity and a specificity of 89.6% and 100.0%, respectively, and a positive predictive value and a negative predictive value of 100.0% and 76.9%, respectively, whereas small-bowel series were 27.6%/100.0% and 100.0%/32.3%.. CE is more accurate in detecting small-bowel inflammatory changes suggestive of Crohn's disease than conventional studies. CE, combined with ileocolonoscopy, may be proposed as a first-line investigation of the small intestine in cases of uncomplicated known or suspected Crohn's disease.

Topics: Adult; Biopsy; Crohn Disease; Diagnosis, Differential; Endoscopy, Gastrointestinal; Enema; Female; Follow-Up Studies; Humans; Ileitis; Ileum; Male; Methylcellulose; Predictive Value of Tests; Prospective Studies; Radiography; Reproducibility of Results; Telemetry

A feasibility study was conducted to evaluate two biphasic computed tomographic (CT) enterography protocols, a noninvasive CT technique with water administered perorally and CT enteroclysis with methylcellulose administered through a nasojejunal tube, in 23 patients known or suspected to have Crohn disease. Results were compared with the results of fluoroscopic small bowel examination and terminal ileoscopy for the detection of active Crohn disease in the terminal ileum. Luminal distention did not differ significantly between the two CT protocols. Arterial phase imaging was noncontributory in 22 of 23 cases. The noninvasive peroral water CT enterography protocol had similar accuracy (12 of 15 cases, 80%) for enabling the detection of active Crohn disease in comparison with CT enteroclysis with nasojejunal tube (seven of eight, 88%) and fluoroscopic small bowel examination (17 of 23, 74%). No fistulas were missed with use of either CT technique. The authors conclude that noninvasive peroral portal venous phase CT enterography with use of water is an accurate and feasible technique for detecting active small bowel inflammation in patients with Crohn disease.

Topics: Administration, Oral; Adult; Barium Sulfate; Contrast Media; Crohn Disease; Endoscopy, Gastrointestinal; Feasibility Studies; Female; Fluoroscopy; Humans; Ileitis; Ileum; Intubation, Gastrointestinal; Iopamidol; Male; Methylcellulose; Metoclopramide; Middle Aged; Sensitivity and Specificity; Tomography, X-Ray Computed

To compare small bowel lesions, especially stenoses, with conventional enteroclysis, static MRI and dynamic MR-enteroclysis.. Forty-two patients with Crohn's disease or other suspected small bowel lesions were examined. MRI was performed in a static and a dynamic way either within one hour after conventional enteroclysis (n = 30) or a few days afterwards (n = 12). In order to monitor bowel filling and to characterize stenoses in a dynamic fashion, 4 series of coronal T2w HASTE breath hold sequences were used, first without additional bowel opacification and then during administration of 1,5 l methyl cellulose via a naso-intestinal tube in the MR unit. Intravenously applied Buscopan was used to reduce bowel movement.. In 4 out of 42 Patients, application of methylcellulose was limited to 1000 ml because of gastrointestinal complaints or visible gastral reflux. All patients could be evaluated. Static MRI performed within one hour after conventional enteroclysis and no additional bowel opacification showed insufficient bowel distension. Distension was still better than in MRI without prior application of contrast medium. On the contrary, dynamic MR - enteroclysis lead to controlled and complete bowel distension which allowed for significantly better evaluation of normal bowel anatomy and pathological alterations of the gut. Because of a better bowel distension and dynamic evaluation, MR-enteroclysis revealed significantly more stenoses (n = 42) than MRI obtained with less distension (n = 27, p < 0.001), and characterization of lesions was comparable to conventional enteroclysis (p < 0.001). Fixed and non-fixed stenoses could be differentiated by dynamic MR-enteroclysis. Furthermore, extraluminal complication of Crohn's disease such as abscesses and fistulae or large bowel manifestation of disease were shown in 13 patients.. Dynamic MR-enteroclysis is feasible in routine diagnostic work-up of the small bowel. It is superior in depicting intra- and extraluminal manifestation of small bowel lesions and enables characterization of stenoses comparable to conventional enteroclysis.

Topics: Adolescent; Adult; Aged; Contrast Media; Crohn Disease; Enema; Female; Humans; Image Enhancement; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Magnetic Resonance Imaging; Male; Methylcellulose; Sensitivity and Specificity

To compare the cost-effectiveness of magnetic resonance imaging (MRI) and enteroclysis in patients with Crohn's disease (CD).. A decision analytic model was performed considering the correct diagnoses of CD and complications such as fistulas and abscesses as effects. Costs were estimated in Euro([symbol: see text]) using German fee schedules.. MRI was more effective and more costly compared with enteroclysis. Incremental cost-effectiveness of MRI versus enteroclysis was [symbol: see text]1,595 per additional correctly diagnosed patient.. The use of MRI in the work-up of patients with CD cannot be generally recommended from an economical perspective, but results of sensitivity analysis suggest that in patients with high prevalence of complications, MRI becomes as cost-effective as enteroclysis, which is accepted standard diagnostic imaging.

Topics: Abdominal Abscess; Barium Sulfate; Contrast Media; Cost-Benefit Analysis; Crohn Disease; Decision Support Techniques; Diagnosis, Differential; Germany; Humans; Intestinal Fistula; Magnetic Resonance Imaging; Methylcellulose; Predictive Value of Tests; Prevalence; Radiography; Sensitivity and Specificity

Assessment of 3 different rectal contrast agents (water, methylcellulose, ultrasound gel) for their suitability for colorectal imaging in multislice CT (MS-CT).. 115 patients with colorectal diseases underwent MS-CT with varying, rectal contrast agents in a prospective study. Images were assessed by 2 independent CT-experienced radiologists. 6 criterias were evaluated, using a 5-point scale.. Methylcellulose (MC) proved to be significantly superior to ultrasound gel (US). Especially, differentiation of healthy and diseased bowel and bowel wall and lumen were aided, which was proven by quantitative analysis of attenuation values. Rectal distension is greater using MC or US than for water. More proximal parts of the colon could be better distended with water. The interobserver correlation was good (kappa 0.76).. Rectal filling with MC significantly improves diagnostic confidence in colorectal examinations. Ease of administration and lack of problems suggest its use as a clinical routine tool.

Topics: Adult; Aged; Aged, 80 and over; Colitis, Ulcerative; Colonic Diseases; Colorectal Neoplasms; Contrast Media; Crohn Disease; Female; Gels; Humans; Male; Methylcellulose; Middle Aged; Observer Variation; Prospective Studies; Radiography, Abdominal; Rectal Diseases; Tomography, X-Ray Computed; Water

During the last few decades introducing many of new radiologic methods, diagnostic conditions and facilities of Crohn's disease has became markedly improved. Appropriate using of these technics definitely modifies the management of patients with known or suspected Crohn's disease serving reliable information about extent, severity and possible complications of disease. Enteroclysis and Computed tomography are the two major and basic methods to disclose or confirme diagnosis of Crohn's disease, obtain appropriate inforination about disease either with mucosal, transmural or extraintestinal manifestation.. We evaluated 281 patients who were referred in our institution under suspition of Crohn's disease. Enteroclysis and abdominal spiral CT in all cases were carried out usually within 1 week. The 172 patients underwent abdominal spiral CT as the primary examination to evaluate diagnostic value of spiral CT in this entity, while 109 patiens had enteroclysis followed by abdominal CT. In 11 cases we also perforined CT enteroclysis with administration of 0.5% methylcellulose solution thorough nasojejunal tube controlled by electric motor driven contrast pump. Results were compared with final clinical, pathological or surgical data were available.. From the 281 patients eventually 74 proved Crohn's disease; sensitivity and specificity of enteroclysis proved to be 96 and 98%, while spiral CT sensitivity and specificity was 94 and 95%, respectively. Enteroclysis was superior to the spiral CT in demonstration of early lesions and functional disorders, while spiral CT proved to be essential in evaluation of transmural and extraintestinal complications.. Regarding enteroclysis and spiral CT as complementary methods, they provide excellent results in diagnosis of Crohn's disease.

Topics: Adult; Barium Sulfate; Contrast Media; Crohn Disease; Female; Humans; Intestine, Small; Male; Methylcellulose; Sensitivity and Specificity; Tomography, X-Ray Computed

The aim of this study was to evaluate the accuracy of enteroclysis in the diagnosis of Crohn's disease of the small bowel in a group of consecutive patients. From January 1992 to December 1995, 165 patients with suspected Crohn's disease of the small bowel presented to our institution for enteroclysis. In 14 patients up to three enteroclysis exams were performed. Most patients (78%) underwent colonoscopy and retrograde ileoscopy. In the remaining patients clinical follow-up was used as gold standard. In 79 patients no radiographic abnormalities were found. Sixty-one patients (40 men and 21 women; mean age 34.2 years) had a radiological diagnosis of Crohn's disease. This involved the terminal ileum in 39 patients (64%) either alone (n = 25) or in association with the pelvic ileum (n = 14). In 12 of these patients retrograde ileoscopy was not feasible. Twenty-one patients underwent surgery. In 4 patients pathology revealed diseases other than Crohn's. These patients had all ileocecal diseases (tuberculosis = 2; non-Hodgkin's lymphoma = 1; adenocarcinoma = 1). One false-negative result was observed. Overall, enteroclysis showed a sensitivity of 98.2% and a positive predictive value of 93.4%. Enteroclysis is a sensitive technique in evaluating both the extent and the severity of small bowel involvement in Crohn's disease, although the overlap of radiographic findings may hamper its accuracy when the disease is confined to the ileocecal area.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Child; Contrast Media; Crohn Disease; Diagnostic Errors; Enema; Female; Humans; Intestinal Neoplasms; Intestine, Small; Male; Methylcellulose; Middle Aged; Predictive Value of Tests; Radiography; Retrospective Studies; Sensitivity and Specificity

The authors describe a technique for obtaining a double-contrast hypotonic duodenogram after a small-bowel enema examination. They have used this technique successfully in patients with unexplained gastrointestinal bleeding and to assess duodenal involvement in patients with Crohn's disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Contrast Media; Crohn Disease; Duodenal Neoplasms; Duodenum; Enema; Gastrointestinal Hemorrhage; Humans; Hypotonic Solutions; Methylcellulose; Middle Aged; Radiography

The intravenous use of metoclopramid (paspertin) and ceruletid (Takus) reduces the time required for fractionated double contrast examinations of the small bowel. It also improves visualisation of individual sections of the small bowel, particularly the terminal ileum. The value of these drugs has been assessed in a prospective study in 48 patients with suspected Crohn's disease.

Topics: Barium Sulfate; Ceruletide; Contrast Media; Crohn Disease; Drug Evaluation; Gastrointestinal Motility; Humans; Intestine, Small; Methylcellulose; Metoclopramide; Prospective Studies; Radiography; Time Factors

In certain diseases originating from the small intestine the peroral application of contrast medium can complete with enteroclysis. The use of methylcellulose MH 1000 proved to be a good compromise between viscosity ans stability of mucosal coating. It allowed good image quality in all segments of the small bowel particularly in the distal ileum. Therefore, this method is clearly indicated in Crohn's disease. Good results were also obtained in delineating tumours, radiation enteritis and ischaemic enteritis. With few patients exhibiting reduced small bowel mobility and/or who are incapable of drinking adequate volumes of contrast medium the results of the oral method are rather unfavourable.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Barium Sulfate; Crohn Disease; Drug Evaluation; Humans; Intestinal Neoplasms; Intestine, Small; Methylcellulose; Middle Aged; Radiographic Image Enhancement; Solutions; Viscosity

Our study was directed not only towards the diagnosis of small bowel Crohn's disease, but especially to a quantitative analysis, for a correct therapeutical approach. This experimental trial is based on the relationship between radiological evidence, measured during small bowel enema, and the seriousness of the morphological and functional damage to the intestinal mucosal membrane, evaluated with a post-heparin diamine-oxidase activity test. With this method we studied 35 selected patients; 16 of them were affected by the disease with an exclusive localization in the small bowel and 5 have been considered separately, because 3 patients had already been operated and the other 2 showed different localizations. In our results, the two parameters were not constantly related to each other. In other words the enema's morphological data sometimes do not accord with the mucosal membrane integrity index expressed by the enzyme. Anyway the importance of this study is the attempt of making an objective comparison between an anatomic situation and its functional consequence. These aspects have a great significance in Crohn's disease.

Topics: Amine Oxidase (Copper-Containing); Barium Sulfate; Crohn Disease; Humans; Intestine, Small; Methylcellulose; Radiography

Topics: Adolescent; Adult; Barium Sulfate; Crohn Disease; Humans; Ileum; Methylcellulose; Middle Aged; Radiography

The experiences from a total of 303 small intestine examinations of different techniques show that especially the double-contrast representation using barium sulfate and air achieves the best diagnostical findings. The double-contrast representation can be achieved by an antegrade small intestine enema (enteroclysis) or within the conventional small intestine passage by retrograde air insufflation. These examination techniques make optimal fine diagnostics especially of the lower ileum possible. The indications for the different methods are explained.

Topics: Air; Barium Sulfate; Cellulose; Contrast Media; Crohn Disease; Diverticulum; Enema; Humans; Intestinal Diseases; Intestine, Small; Methylcellulose; Radiography; Tissue Adhesions; Water

Coloscopic small bowel enema, a new diagnostic method, permits small and large intestinal investigation in one session. A coloscope is required equipped with a circular mounted balloon at the distal end. The endoscope is placed into coecum using the conventional technique (coloscopy). After intubation of the ileocoecal valve the balloon is inflated in the terminal ileum. This prevents reflux of the contrast medium and methyl-cellulose solution which are instilled into the small bowel through the endoscope instrumentation bore. Double-contrast investigation of the small bowel is particularly suitable for diagnosis of inflammatory diseases (e.g. Crohn's disease), Meckel's diverticulum and polypoid lesions such as carcinoid tumours.

Topics: Adult; Barium Sulfate; Colitis; Colonoscopy; Crohn Disease; Female; Humans; Intestine, Small; Male; Methylcellulose; Middle Aged; Radiography

Topics: Barium Sulfate; Child; Child, Preschool; Contrast Media; Crohn Disease; Humans; Hyperplasia; Intestinal Neoplasms; Intestine, Small; Lymph Nodes; Meckel Diverticulum; Methylcellulose; Radiography

Topics: Barium Sulfate; Contrast Media; Crohn Disease; Enema; Evaluation Studies as Topic; Humans; Intestine, Small; Methylcellulose; Radiography

The value of double contrast small bowel enema via duodenal intubation using barium sulphate and methylcellulose as contrast media was assessed in 250 patients. In cases of small bowel obstruction it represented the first-line investigation after a plain abdominal film. It was performed electively in patients of painful bowel syndrome, in cases of malabsorption, in cases of endoscopically or radiologically diagnosed colitis and in patients with Crohn's disease. On the basis of our results we believe double contrast small bowel enema to be the most reliable investigation in the localization and identification of small bowel lesions.

Topics: Barium Sulfate; Contrast Media; Crohn Disease; Enema; Humans; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Intubation, Gastrointestinal; Malabsorption Syndromes; Methylcellulose; Radiography

A modification of the small-bowel enema with barium and methylcellulose is described and findings in 300 consecutive examinations compared with the clinical diagnoses. The radiograph was positive in 37% of cases and the clinical examination in 29%. Diseases and abnormalities of the small bowel, including motility disorders, can be diagnosed with high sensitivity and specificity using this technique.

Topics: Adenocarcinoma; Adult; Barium Sulfate; Celiac Disease; Crohn Disease; Evaluation Studies as Topic; Gastrointestinal Motility; Humans; Intestinal Diseases; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Methods; Methylcellulose; Radiography