What is a barium enema?
A barium enema is a radiology procedure used to detect abnormalities in the large intestine (colon). Other names for barium enema include “lower gastrointestinal (GI) tract” or “lower GI exam.” If a child is having intestinal symptoms, a barium enema may be used to help determine the cause.
Barium enema exams use a contrast agent (barium) that is placed into the child’s rectum. A special X-ray technique called fluoroscopy allows the radiologist to see real-time moving images of the structures in the child’s abdomen. The images produced by fluoroscopy can be digitalized and stored on a computer to be viewed at any time. Scans can also be sent via the Internet, which allows doctors to view studies remotely.
Any time a child has intestinal or abdominal symptoms, the large intestine might be the source of the problem. There are a wide variety of disorders that can affect the colon. Lower GI exams can help diagnose:
- Hirschsprung disease (a birth defect that causes blockage in the child’s colon)
Symptoms that might require evaluation with barium enema include:
- Persistent diarrhea or constipation
- Blood in stool
- Unexplained weight loss
- Unexplained anemia
- Persistent abdominal pain
- Barium enema is a minimally invasive exam with few complications.
- No anesthesia is required for the exam.
- The procedure may allow the child to avoid a more invasive evaluation such as colonoscopy.
- Barium given as an enema does not enter the blood stream.
- Allergic reactions during barium enema are very rare.
- X-ray exams may increase the risk of cancer very slightly, but it is unlikely that one X-ray exam alone increases the cancer risk significantly. In most cases, the benefit of the exam far outweighs the risk. The parts of the body not examined will be protected from X-rays as much as possible.
- In very rare cases, barium can leak through a hole in the intestine and lead to inflammation of the surrounding tissues.
- In extremely rare cases, barium can lead to lower GI obstruction.
- Vary rarely, barium can cause an allergic reaction.
- Barium enema is typically performed in an ARA imaging center. The test takes about 30 to 45 minutes.
- Your child will be asked to change into a gown.
- Your child will be asked to lie on an exam table with his or her knees bent up close to the stomach.
- The technologist will place the tip of a small rubber tube into your child’s rectum and apply tape to hold the tube in place.
- Through the enema tube, barium will be administered into your child’s large intestine. Your child will feel the urge to have a bowel movement.
- Special X-ray equipment will be moved close to your child to take pictures of the barium-filled intestines. The images will be viewed by a radiologist or technologist on a nearby monitor.
- After the images are taken, the enema tube will be removed, and your child may use the bathroom to empty the barium and any bowel content.
- After using the bathroom, your child will be asked to lie back on the exam table. More images will be taken to see if enough barium was emptied from your child’s intestines.
- Once all the images are taken, your child can get dressed.
- Your child’s bowel movements will appear white for a few days after the exam. This is normal.
- Encourage your child to drink plenty of fluids after the exam. Otherwise, they can follow a normal diet.
- If your child experiences constipation after the barium enema, contact your health care provider to see your child needs a mild laxative.
- The child should be accompanied by an adult who is not pregnant since radiation exposure is unsafe for unborn babies.
- If your child has any special needs, please mention this when scheduling the exam.
- No special diet or preparation is required for barium enema in children.
- Nothing should be given rectally to the child for 72 hours before to the exam.
- You may accompany your child during the exam. Gentle, soothing words and hand-holding will help keep your child calm.
- Please do not interrupt or talk to the technologist during the procedure. You may ask questions after the exam is complete.
A radiologist, a physician specifically trained to interpret radiological examinations, will analyze the images and send a signed report to the provider who referred you to ARA. Your health care provider will then share the results with you. Your report will also be available on the patient portal within 3 business days.