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Color enhanced image from a normal double contrast barium enema exam. Barium enema is performed by a radiologist who instills a liquid barium preparation into the large intestine through a tube placed in the rectum. This is done under fluoroscopy (real time x-ray). Double contrast BE or air contrast BE is performed by putting a small amount of barium in only to coat the walls of the large intestine. Then air is put into the large intestine behind the barium which allows the walls to be outlined and well seen. Barium enemas are performed for a variety of reasons including chronic diarrhea, chronic constipation, rectal bleeding and abdominal pain. Some of the diseases which can be diagnosed by this technique are colon cancer, intestinal polyps, inflammatory bowel disease such as chron's disease or ulcerative colitis, diverticulosis and diverticulitis.