Barium Glucagon

Reactions to other constituents of barium sulfate enemas have been recognized (SEDA-18, 441) and could be as common as one in 1000. They vary from urticarial rashes to severe anaphylactic reactions, and can be particularly severe in patients with asthma (13). Hypersensitivity to the latex balloon catheter used in double contrast barium enemas appears to be a common mechanism (14), but hypersensitivity to glucagon, to the preservative methylparabens, or to other additives seems to be responsible in some cases. Insofar as the latex balloon is concerned, thorough washing will remove the allergen responsible for the reaction (15). 

Buscopan or glucagon is used to inhibit gastrointestinal activity while imaging is taking place. Metoclopramide is used to speed up transit time of barium in follow-through examination... 

Goei R, Nix M, Kessels AH et al (1995) Use of antispasmodic drugs in double contrast barium enema examination glucagon or buscopan Clin Radiol 50 553-557 Gollub MJ, Jhaveri S, Schwartz E et al (2005) CT colonography features of sigmoid diverticular disease. Clin Imaging 29 200-206... 

Bova JG, Jurdi RA, Bennett WF (1993) Antispasmodic drugs to reduce discomfort and colonic spasm during barium enemas comparison of oral hyoscyamine, iv glucagon, and no drug. AJR 161 965-968... 

There are two intravenous spasmolytics available for CT colonography hyoscine butylbromide and glucagon hydrochloride. Both produce hypotonia in smooth muscle within the colonic wall and are used widely to improve distension during double contrast barium enema. However, while both agents have been shown to improve patient perception during barium enema, only hyoscine butylbromide reliably improves distension (Goei et al. 1995 Bova et al. 1993). As a result, it is widely utilized for barium enema across Eimope (hyoscine butylbromide is not licensed for use in the USA). 

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