What is a barium enema?

A barium enema is type of fluoroscopy procedure that allows us to see images of your child’s colon. We do this by using an X-ray machine and a contrasting agent that is administered through the rectum. In most cases, we perform a barium enema to help us diagnose why a child is having difficulty with bowel movements.

A fluoroscopy procedure is an imaging technique that uses X-rays to create "real-time" or moving images of the body. It helps doctors see how an organ or body system functions. A radiologist (X-ray doctor) and radiologic technologist perform the procedures together.

In most of these types of exams, your child will lie on the table while the X-ray machine, called a fluoro tower, is brought overhead. The fluoro tower has a curtain on it; it's like being in a tent or a small car wash. You, the doctor and your child will be able to see the images on a television monitor in the room.

What should you do prior to the exam?

There are different preparations, according to your child's age, diagnosis or reason for exam. Please pay close attention to the following instructions.

If the reason for the exam is to evaluate for Hirschprung's disease or constipation, there are no special preparations. Please skip the bulleted instructions below.

Any other indication requires the following preparations

• Increase your child’s fluid intake for 24 hours prior to the exam.
• Be sure to limit your child to clear fluids only 24 hours prior to the exam.
• On the evening before the exam at dinner time give your child Milk of Magnesia under the following dosage guidelines:
  Under 2 years: none
  2-5 years: 2 teaspoons
  6-11 years: 2 tablespoons
  12 years and older: 4 tablespoons
• Children 2 years of age and older need to be given one Fleets enema the night before the exam and one Fleets enema on the morning of the exam.

If your child has a noted allergy to radiographic contrast, additional preparations may be necessary.

Dress your child comfortably, in clothes that are easily removed. Your child will be given a gown to change into for the procedure.

You may want to bring a snack or drink for your child to have after the exam.

Note: Parents will be allowed to accompany their child into the exam room. Other arrangements should be made for siblings.

Women who are pregnant or may be pregnant will be asked to leave the exam room during the procedure. Please make sure that there is someone else available to accompany your child during the exam, if needed.

What should you expect during the exam?

The technologist will ask why the barium enema is being performed and will explain the procedure to both you and your child. This exam takes an average of 30 minutes from start to finish.

• We will insert a tiny tube into your child's rectum. The length and width of the tube is determined by the age and/or size of your child.
• The technologist will use tape on your child's bottom so that the tube will stay in place during the study. The tube will be connected to a bag containing a contrast agent.
• The radiologist will move the fluoroscopy machine, or camera, over your child and the contrast material will be administered. While the contrast material is flowing into your child's bowel, the radiologist will roll your child from side to side in order to get good diagnostic images.
• After your child's large bowel has been evaluated, we’ll remove the tube from your child's rectum and either ask him to go to the bathroom or put him in a diaper until he has a bowel movement. After your child has a bowel movement, we may take additional pictures.

If you’d like, one of our child life specialists will help you prepare and support your child during the procedure. We can also arrange to have a child life specialist at your child's appointment to explain the procedure in developmentally appropriate ways and to help your child better cope with the stress of the hospital experience.

Radiation safety for fluoroscopic procedures

We are careful to limit the dose of radiation your child receives. Your child will wear a lead shield during the procedure. We also adjust the dose of radiation according to the size of the child and we administer the X-rays in a pulsed, rather than constant fashion to minimize the amount of radiation.

What should you do after the exam?

After the study, it is important to give your child extra fluids for the day, because the barium may cause constipation.

If there are any problems or questions about constipation please call your primary care physician.

When your child does have a bowel movement, it may appear white or grayish — do not be alarmed! The barium may cause this discoloration.

Test results

The images from your child's exam are interpreted on the same day and a report sent to your child's physician's office.

Here is an example of what your child's exam may look like.