Diagnosis of ulcerative colitis--barium enema examination

Barium enema is useful especially for differential diagnosis of right sided type or segmental type of ulcerative colitis from other inflammatory bowel diseases. Compared with endoscopical examination, it provides more objective informations about the range of affected colon which is necessary for the choice of treatment strategy to the reluctant case. However, as preparation procedures may cause aggravation of ulcerative colitis, an unnecessary barium study should be avoided. Even the case in remission stage, it is advisable to add 40 to 60 mg of water-soluble predonisolone to barium solution. Roentogenographic diagnosis of ulcerative colitis is not difficult, in so far as two major points are properly evaluated. The first is the presence or absence of haustration, and the second is mucosal surface of the colon, namely, multiple ulcers or erosions distributing diffusely and continuously in active stage, or granular mucosa and disarray of network pattern of colonic mucosa in remission stage.