Digital X-Ray & Contrast Studies

What is an X-ray?

X-rays involve exposing a body part to a small dose of radiation to produce an image of an internal structure. The most common use of X-rays is to identify and treat bone fractures.

X-rays can also be used to diagnose and monitor the progression of degenerative diseases such as arthritis. While X-rays play a role in the detection and diagnosis of cancer, CT and MRI are usually better at defining the extent and nature of a suspected cancer.

Contrast studies involve a series of X-rays being taken after contrast material has been introduced into the area being studied to provide added image detail.

What will an X-ray exam be like?

X-ray is a fast and easy procedure. The technologist will position a patient on the examination table and place a digital plate under the table in the area of the body to be imaged. Then the technologist will step behind a radiation barrier and ask the patient to hold still without breathing for a few seconds.

The radiographic equipment will be activated, sending a beam of radiation through the patient’s body to the digital plate. The digital plate then sends the information collected to a computer for processing, viewing and digital storage.

Contrast Studies

Esophagram: An examination of the pharynx (throat) and esophagus using still and fluoroscopic X-ray images. The X-ray pictures are taken after the patient drinks a solution that coats and outlines the walls of the esophagus (also called a barium swallow).

Upper GI Series: A series of X-rays of the esophagus, stomach, and small intestine (upper gastrointestinal, or GI, tract) that are taken after the patient drinks a barium solution. Barium is a white, chalky substance that outlines the organs on the X-ray.

Small Bowel or Small Intestine Series: A series of X-rays of the part of the digestive tract that extends from the stomach to the large intestine.

Barium Enema / Lower GI Series: A series of X-rays of the lower intestine (colon) and rectum that are taken after the patient is given an enema with a white, chalky solution that contains barium. The barium outlines the intestines on the X-rays.

These X-rays permit the detection of colon and rectal abnormalities, including diverticulosis, diverticulitis, abnormal colon movement, dilation (widening) of the colon, polyps and cancers of the colon and rectum. Air can be instilled into the colon along with the barium contrast medium to further define structures of the large bowel and rectum.

Polyps and small cancers are more readily found using this method, which is called an air contrast barium enema or a double-contrast barium enema. This is the only kind of barium enema that is appropriate for detecting colorectal polyps and potentially curable colorectal cancers.

Intravenous Pyelogram (IVP): An X-ray examination of the kidneys, their drainage to the bladder, and the bladder.

Hysterosalpingogram: X-ray of the uterus and Fallopian tubes; usually done in diagnosing infertility to see if there any blockages.

Arthrogram: X-ray of a joint after the injection of a contrast medium to more clearly visualize the joint.

X-Ray/Contrast Studies Requiring Preparation

Upper GI X-Ray Prep

  • Do NOT eat or drink after midnight on the morning of the exam
  • Do not chew gum or smoke after midnight, as these activities can cause stomach secretions, which also may degrade the quality of the images
  • Patients should bring their prescription and insurance card and photo ID
  • Arrive at our office 15 minutes prior to the scheduled appointment time

X-Ray- Small Bowel / Small Intestines X-ray Prep

  • Do not eat or drink after midnight on the morning of the exam
  • Do not chew gum or smoke after midnight, as these activities can cause stomach secretions, which may degrade the quality of the images
  • Patients should bring their prescription and insurance card and photo ID to the appointment
  • Arrive at our office 15 minutes prior to the scheduled appointment time

Barium Enema X-Ray Prep

The barium enema is an examination of the colon or large intestine. It can be important in diagnosing disorders of the large intestine. It requires great attention to detail.

  • It is essential that the colon be thoroughly cleansed
  • Even a small amount of retained stool may hide abnormalities
  • If the bowel is completely empty, the barium enema will be less uncomfortable

The barium must be given by a physician in the imaging facility. The radiologists will perform the procedure with fluoroscopy and obtain a number of images using X-rays during the enema. The radiologist will write a consultation report of the findings for the patient’s primary care physician.


Please follow a clear liquid diet the entire day before an exam. Clear liquids include:

  • Clear juices without pulp (apple, white grape, lemonade, white cranberry)
  • Water
  • Clear broth or bouillon
  • Coffee or tea (without milk or non-dairy creamer)
  • All of the following that are not red or purple:
  • Gatorade
  • Carbonated and non-carbonated soft drinks (Sprite, 7-Up, ginger ale)
  • Plain Jell-O (without added fruit or toppings)
  • Ice popsicles

Throughout the day, please drink plenty of liquids to prevent dehydration. The liquids are an important part of the preparation.

At 5 p.m:
Drink one 10-ounce bottle of Magnesium Citrate and follow this with 8 ounces of clear liquids. Drink a minimum of three additional 8-ounce glasses of clear liquids throughout the evening.

Continue to follow a clear liquid diet. Patients may resume a normal diet after their exam.

About 1½ hours prior to leaving for your exam, use one Dulcolax suppository. This should result in a bowel movement within 30 minutes. Bring a list of all prescription medications, over-the-counter medications and herbal supplements – including frequency and dosage — to your appointment.

Patients should bring their primary care physician’s prescription and referral to the exam. Call 908-874-7600 with any questions.


Patients should contact their primary care doctor if they:

  • Are diabetic and require insulin before starting the preparation
  • Have an inflammatory condition of the gastrointestinal tract, such as Chron’s disease, regional enteritis or ulcerative colitis
  • Have previously had an adverse response to any of the laxatives used in this preparation
  • Suffer from severe or chronic diarrhea

Adult IVP X-Ray Prep
This is an X-ray examination of the kidneys or bladder. For this study to be of greatest value, it is necessary for a patient’s bowel to be as clean as possible. For best results, follow the directions below.

Required Preparation


5 p.m.
Eat a light supper (i.e., white meat of chicken or turkey, baked potato, Jell-O, clear fruit juice) and omit all dairy products unless on ulcer diet. Include at least two glasses of water.

8 p.m.
Drink one 10 oz. bottle of Magnesium Citrate (cold).

10 p.m.
Take three Dulcolax (Bisacody L) tablets with at least two full glasses or more of water. Do not crush or chew tablets. Swallow them whole within one hour of antacids or milk.


Do not eat or drink anything.

1 ½ hours before exam
Use one Dulcolax (Bisacody L) rectal suppository as follows:

  1. Unwrap suppository and insert in rectum.
  2. Examination

Lie on left side for 15 minutes, or longer if possible, and then have a bowel movement.

Report to the office at the scheduled time.

What You’ll Need

Purchase the following items from the pharmacy:

  • One 10-ounce bottle Magnesium Citrate
  • Three Dulcolax tablets (Bisacody L)
  • One Dulcolax rectal suppository (Bisacody L)

The value of the examination will depend on complete cleansing of the bowel. Occasionally the above laxative products cause multiple loose movements.


Patients may continue taking any medications prescribed by their physician. However, if they take a diuretic (water pill), omit it on the day of the examination.

EXCEPTION: Do not take Glucophage