• Defogram or Defocography

    Estimated time: 30 minutes, although you can expect to be in Radiology Department for 1 ½ - two hours

    Anatomy involved: Lower colon or rectum, bladder, vagina and small bowel

    Performed by: A radiologist or radiology physicians' assistant, and assisted by a technologist.

    Preparation: No preparation is necessary. However, you should inform your referring physician and the radiologist who will be performing the procedure of any allergies that you might have, particularly to iodinated contrast material.


    Overview

    A defogram or defocography study is a painless X-ray examination that provides information on the function of the lower colon or rectum, and the surrounding organs such as the bladder, vagina and small bowel. A defogram analyzes the pelvic muscles, specifically their strength and control. Contrast is introduced rectally as in a barium enema, however a defogram involves the patient actually pushing to evacuate the contrast material as though having a bowel movement.

     

    Before and During the Procedure

    First, you will be asked to change into a hospital gown. Then you will be asked to drink a cup of barium, which enables the radiologist to view the small bowel in the pelvic area. You should finish the drink in about 10 to 15 minutes. There will then be a wait of approximately 45 minutes for the barium to reach the lower portion of small bowel.

    When you are called into the X-ray room, you will be asked to lie on your left side on the X-ray table. At this time, for women, a barium paste will be administered into the vaginal area in order to visualize the movement of the vagina in the pelvic floor when you are bearing down. Next, with a small tube, the radiologist will insert just enough barium paste into the rectum to fill it. Barium is inert and not absorbed in your system. Allergies to barium are extremely rare.

    The radiologist then removes the tubes and you will be asked to step down from the table. The technologist then adjusts the X-ray table in an upright position so that you will be able to sit down on a bedpan that rests on a platform attached to the table. You will then sit with your left side against the X-ray table and the radiologist will instruct you to control your rectal muscles in different ways such as tightening and pushing. These different maneuvers help in evaluating the pelvic area.

    You should expect to be in the Radiology Department for about 1 ½ to 2 hours on the day of your exam. This includes the time to sign in, the time involved in drinking the barium, and the 45 minute wait time for the barium to reach the distal small bowel. The time to perform the actual defocography study is approximately 30 minutes.

     

    After the Exam

    The results of the study will be sent to your doctor and your doctor will pass on this information to you.

     

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