What is Small Bowel Follow Through?
Small bowel follow-through (SBFT) is a radiographic examination that provides a detailed visual representation of the small intestine, its morphology, and its functionality. In this article, we will delve into the details of what SBFT is, its significance, and its uses.
What is a Small Bowel Follow Through Exam?
A small bowel follow-through exam is a non-invasive diagnostic procedure that uses x-rays and fluoroscopy to visualize the small intestine. During the examination, the patient is instructed to drink a liquid solution containing barium sulfate, a radiocontrast agent, and a mild laxative. The barium coating allows the small intestine to be visible on the x-ray images, enabling doctors to evaluate its shape, size, and any potential abnormalities.
Significance of Small Bowel Follow Through
SBFT plays a crucial role in diagnosing and monitoring various small bowel disorders, including:
- Celiac disease: SBFT helps to detect malabsorption of nutrients and villous atrophy, characteristic features of celiac disease.
- Crohn’s disease: SBFT aids in diagnosing the extent of inflammatory lesions and detecting potential complications, such as intestinal obstruction or fistulae.
- Gastrointestinal bleeding: SBFT can help identify the source of bleeding and evaluate the extent of hemorrhage.
- Malabsorption: SBFT helps diagnose and monitor conditions like bacterial overgrowth, sprue, and lymphangiectasia.
Procedure of Small Bowel Follow Through
The procedure typically takes about 30-60 minutes to complete and is performed in the following steps:
- Patient Preparation: Patients are asked to fast for 6-8 hours before the exam to minimize the effects of food on the results.
- Administration of Barium Solution: Patients drink the barium solution, which contains 40-50% w/v barium sulfate and 5-10% w/v of a mild laxative.
- Radiographic Imaging: X-ray images are taken every 15-20 minutes, starting from 1 hour after barium ingestion, to monitor the passage of barium through the small intestine.
- Fluoroscopic Imaging: Fluoroscopic imaging is used to guide the x-ray machine and obtain optimal images.
- Data Interpretation: Radiologists and gastroenterologists review the images to detect any abnormalities, such as:
| Abnormality | Description |
|---|---|
| Narrowing | Abnormal narrowing of the small intestine |
| Obstruction | Blockage of the small intestine |
| Filling defects | Abnormalities within the lumen of the small intestine, such as polyps, ulcers, or masses |
| Ulceration | Abnormal mucosal lining, often seen in inflammatory conditions |
| Thickenings | Thickened mucosa or muscular wall |
Precautions and Limitations
- Patient Precautions: Patients should not consume solid foods for 12-24 hours after the exam, and they may experience abdominal discomfort, diarrhea, or bloating.
- Contrast Reaction: Rarely, patients may experience an allergic reaction to the barium sulfate.
- Radiation Exposure: The examination involves minimal radiation exposure, but pregnant or breastfeeding women should discuss the risks and benefits with their doctor.
- Interpretation Limitations: SBFT is not effective in diagnosing some conditions, such as Crohn’s disease or ulcerative colitis, if the symptoms are not typical or the lesions are small.
Conclusion
Small bowel follow-through is a valuable diagnostic tool for evaluating the small intestine and its functions. It provides detailed images of the small intestine, enabling doctors to diagnose and monitor various conditions. While SBFT is not without its limitations, it remains a valuable addition to the armamentarium of diagnostic techniques for gastroenterologists and radiologists. By understanding the significance, procedure, and limitations of SBFT, healthcare providers can effectively use this exam to provide high-quality patient care.
