A barium enema is a video X-ray of your child’s colon (also called the large intestine) to see how it is functioning and to visualize it accurately. We perform the procedure by administering a special fluid called contrast through a small tube placed in the rectum and viewing the colon with live X-rays. Although the procedure is called a barium enema, in most cases Cystografin (a clear fluid) is used instead of Barium (a thick, white fluid). Chronic constipation, colon trauma or colon surgery are the most common reasons to need a barium enema.

What to Expect

Your child does not need to prepare by fasting or eating anything special before the barium enema. He or she may eat and drink normally before and after this exam.

Testing takes about 30 minutes and will take place in a private exam room. Your participation has a great impact on the success of the exam and we encourage you to be present to support your child. Throughout the exam we encourage you to help your child stay calm and relaxed by holding his or her hand and talking.

The exam does involve the use of radiation, so women who are pregnant or believe they might be pregnant are not allowed in the exam room. In this case, we strongly encourage you to invite another trusted caregiver to support your child during the exam. Siblings and anyone under the age of 18 are also not allowed in the exam room. Two parents or caregivers are able to stay with your child during the exam.

In most cases a Certified Child Life Specialist (CCLS) will assist in preparing your child before beginning the exam and provide distraction during the exam. The CCLS will also encourage your involvement to help calm your child. To develop your child’s trust, the child life specialist will speak to him or her using age-appropriate language.

Step by step, here is the process for your child’s barium enema:

  • Your child will need to change into a hospital gown.
  • Once your child is on the table he or she will be asked to lay on one side with knees pulled up (fetal position). The radiologist or radiologist assistant will place a small tube into the rectum using lubrication to make the tube placement more comfortable.
  • The tube will be connected to a bag of contrast liquid hanging from an IV pole and the fluid will flow by gravity into your child's colon. (An IV pole holds a bag of liquid above your child so that the liquid can flow downward into your child’s body. It is named for the intravenous [into a vein] tubes often used with it.) This will be uncomfortable and make your child feel the need to have a bowel movement. We will ask your child to “hold it” while we take the X-rays.
  • After the colon is completely full of contrast fluid and we are finished with the X-rays we will drain as much contrast through the tube as possible. We will then remove the tube from your child’s rectum. Your child will then be permitted to use the restroom. If your child is not potty-trained, we may ask you to put a diaper on him or her and wait for a bowel movement.
  • After your child has a bowel movement we will take one final X-ray of your child’s abdomen. 
  • Your child may need to use the restroom frequently for a couple hours after the exam. You may want to bring extra undergarments and clothing for your child.