Modifications to the gas-enhanced small bowel barium follow-through using gastrografin and compression.

The transit time of barium through the small bowel has been assessed in two groups of patients. In 52 patients who were given 300 ml 50% w/v baritop and effervescent tablets, the mean transit time was 78.4 min. In 61 patients who were given 300 ml 100% w/v baritop to which 10 ml of Gastrografin had been added, and who were also given effervescent tablets, the mean transit time was 60.2 min. This difference is highly significant (P less than 0.001). It is suggested that small quantities of Gastrografin act as an accelerator of barium transit by causing the release of serotonin (5-hydroxytryptamine) from the small intestinal mucosa. We believe that the distension of the small bowel lumen achieved by the administration of effervescent tablets improves the quality of the small bowel follow-through examination and also improves its accuracy particularly in the diagnosis of Crohn's disease and small bowel adhesions. The importance of performing the whole examination under fluoroscopic control and the value of compression films is stressed.