title: Barium enema in frail elderly patients.
abstract: BACKGROUND
  Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients.
  
  
  METHODS
  Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed.
  
  
  RESULTS
  One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001).
  
  
  CONCLUSIONS
  The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly.
authors.affiliation: The Geriatric Medical Center, 'Shmuel Harofe', affiliated to the Sackler School of Medicine, Tel-Aviv University, Beer Yacov, Israel. shmuelh@netvision.net.il
authors.forename: R
authors.initials: R
authors.lastname: Segal
authors.forename: A
authors.initials: A
authors.lastname: Khahil
authors.forename: A
authors.initials: A
authors.lastname: Leibovitz
authors.forename: I
authors.initials: I
authors.lastname: Gil
authors.forename: M
authors.initials: M
authors.lastname: Annuar
authors.forename: B
authors.initials: B
authors.lastname: Habot
mesh_terms: D000368:Aged; D001466:Barium Sulfate / Q000494:pharmacology*; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D004733:Enema; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D001466:Barium Sulfate