What is the purpose of a Gastrografin (diatrizoate) enema?

From the Guidelines

Gastrografin enema is a recommended diagnostic procedure for suspected bowel obstruction, particularly when a water-soluble contrast medium is preferred over barium enemas, as it is safer and can help relieve partial obstructions. The procedure involves inserting a tube into the rectum and introducing the Gastrografin solution, which appears radiopaque on X-rays, allowing visualization of the bowel lumen. According to the study by 1, a water-soluble contrast enema is a valid alternative for identifying the site and the nature of obstruction when a CT scan is not available.

Indications and Contraindications

• Gastrografin enema is commonly used to diagnose or treat conditions like bowel obstruction, particularly in cases of suspected adhesive small bowel obstruction or to reduce uncomplicated intussusception in children.
• It is also used to evaluate clinically suspected leaks, anastomotic stenoses, fistulas, and sinus tracts, as mentioned in the study by 1.
• However, it is contraindicated when perforation is suspected, as stated in the study by 1, and barium enemas should be avoided in such cases to prevent chemical peritonitis.

Procedure and Side Effects

• The hyperosmolar nature of Gastrografin draws fluid into the intestinal lumen, which can help relieve partial obstructions by reducing bowel wall edema and stimulating peristalsis.
• Patients should be well-hydrated before and after the procedure since Gastrografin can cause fluid shifts.
• Side effects may include abdominal cramping, diarrhea, and rarely, allergic reactions.
• The study by 1 reports that fluoroscopic contrast enemas performed for the diagnosis of perforation or leak, rectovaginal or rectovesicular fistula, pouchitis, or proctitis can be performed with water-soluble contrast or barium, but water-soluble contrast is preferred if a leak or perforation is suspected.

Diagnostic Accuracy

• The sensitivity and specificity of Gastrografin enema for diagnosing bowel obstruction and other conditions may vary, as reported in the studies by 1 and 1.
• However, it is a useful diagnostic tool when used appropriately, and its therapeutic effects make it a valuable procedure in certain cases.

From the FDA Drug Label

INDICATIONS AND USAGE Diatrizoate meglumine and diatrizoate sodium solution is indicated for radiographic examination of segments of the gastrointestinal tract (esophagus, stomach, proximal small intestine, and colon). CLINICAL PHARMACOLOGY ... Rectal administration is used for examination of the colon;

The Gastrogaffin enema is likely referring to a rectal administration of a contrast agent for radiographic examination of the colon. Based on the provided text, diatrizoate meglumine and diatrizoate sodium solution can be used for this purpose 2 2.

• The solution is indicated for radiographic examination of the colon.
• Rectal administration is a suitable method for examining the colon.

From the Research

Gastrogaffin Enema

• A gastrogaffin enema is a type of contrast agent used in medical imaging to visualize the gastrointestinal tract.
• However, there is no direct mention of gastrogaffin enema in the provided studies 3, 4, 5, 6, 7.

Contrast Agents for Gastrointestinal Imaging

• Contrast agents such as barium sulfate, iodine-based agents, and gadolinium-based agents are commonly used for gastrointestinal imaging 3.
• These agents can enhance contrast to distinguish abnormal lesions from normal structures, allowing for more accurate diagnoses.

Diagnostic Tools for Gastrointestinal Conditions

• Computed tomography (CT) and magnetic resonance imaging (MRI) are important diagnostic tools for evaluating gastrointestinal conditions 3, 7.
• Other diagnostic modalities, such as laboratory studies and endoscopy, may also be used to evaluate patients with gastrointestinal illness 4.

Specific Contrast Agents

• Baros and E-Z-Gas II granules are two effervescent contrast agents that have been compared in a study on double-contrast upper gastrointestinal tract radiography 5.
• Dextran-coated cerium oxide nanoparticles (Dex-CeNP) have been developed as a potential CT contrast agent for imaging the gastrointestinal tract and inflammatory bowel disease 7.