Barium Enema (BE)

A barium enema (BARE-ee-um EN-ee-ma), or BE, is a test that shows the structure of the large intestine and colon. The colon is located below the stomach at end of the large intestine. Digested food passes through the colon on the way out of the body through the rectum.

• X-ray pictures are taken after a special liquid called barium (BARE-ee-um) fills the colon and large intestine through an enema placed in the rectum.
• A barium enema shows doctors how well the large intestine and colon are working.
• A barium enema gives doctors detailed information about your child's large intestine and colon that they cannot learn from a physical examination.

• Your child can resume a normal diet prior to this exam.
• If your child is being evaluated for Hirschprung’s or constipation, they cannot have anything rectally for 72 hours prior to exam.
• You may bring along a “comfort” item—such as a favorite stuffed animal or “blankie”—for your child to hold during the test.

The barium enema is done at the Department of Pediatric Radiology of Children’s Hospital. In the exam room will be a pediatric radiology doctor, who will be taking the X-ray pictures of your child’s large intestine and colon, and an X-ray technologist, who will be helping the doctor. You will see an X-ray machine, a long table and a television screen. You might explain to your child that the X-ray machine is a large camera for taking pictures that will be shown on the screen. If your child has any questions, the doctor or X-ray technologist will be happy to answer them before the test.

Your child will be asked to change into a hospital gown. When your child is ready, the test will begin.

• Your child will be awake during this test.
• Your child will be asked to lie down on the table with his or her knees bent and pulled up close to his or her stomach. The X-ray technologist will help your child do this.
• The X-ray technologist will gently slide the tip of a small rubber tube into your child’s anus, which is the opening of the rectum where bowel movements come out of the body. The tube will be connected to a bag filled with white liquid, which is the barium.
• The X-ray technologist will then place special tape on your child’s buttocks to hold the enema tube in place.
• The barium will move slowly down from the bag through the enema tube into your child’s colon and large intestine.
• As the colon and large intestine fills with the barium, your child will feel as if he or she has to have a bowel movement. This feeling is normal.
• The doctor will begin to take the X-ray pictures as the colon and large intestine fills with the barium. The camera will come close to, but not touch, your child.
• The X-ray pictures will allow the doctor to watch the progress of the barium through the colon and large intestine on the television screen.
• Your child may be asked to roll onto his or her side or stomach to allow the doctor to see different parts of the colon and large intestine on the TV screen.
• When all of the X-ray pictures have been taken, the tape and enema tube will be removed and your child will be able to use the bathroom.
• After your child has used the bathroom, your child will be asked to lie back on the table. The X-ray technologist will then take an X-ray of your child’s abdominal, or belly, area to determine if enough of the barium has been emptied from your child’s colon and large intestine.

As a parent, you may have concerns about radiation exposure. Children’s Hospital takes every precaution to make sure your child is safe.

• Our goal is to do the test correctly and thoroughly, while exposing your child to the smallest amount of radiation necessary to take the X-rays.
• Advances in equipment and film have lowered the amount of radiation your child will receive.
• All of the equipment is inspected regularly.
• Parts of the body that are not being X-rayed will be protected with a lead cover or apron when possible.

We welcome your help and support during this test. Parents or guardians are invited to join their child in the X-ray room. Other children can wait in the waiting room, or the Lemieux Sibling Center if siblings are ages 3 to 12 who are toilet trained.

• This test involves the use of radiation. Women who are pregnant or believe they may be pregnant should limit exposure to X-rays. In this case, please bring another adult who can stay with your child during the test.
• The X-ray technologist will show you where to stand in the examination room during the test. Please follow the instructions of the medical staff performing the barium enema.
• The most important role of a parent and guardian during the test is to help your child stay calm and relaxed, particularly when the tube is being inserted and the enema is being done.
• We encourage you to talk to your child and hold his or her hand.
• Taking long, deep breaths through his or her mouth will help your child feel better when the enema tip is being inserted and when the colon is filling with the barium. You can calmly coach your child to take deep breaths.
• Please do not distract the medical team or interrupt the test in any way.
• We welcome your questions, but please ask them either before or after the test.

A barium enema takes about 30 to 45 minutes. The test is finished when the X-ray technologist and doctor have taken all of the pictures they need and determined that enough of the barium has been emptied from your child's large intestine and colon.

• Before leaving, you will be told about any follow-up care.
• After the test, your child will be able to go to the bathroom.
• Your child’s bowel movements will look white for a day or two because of the barium. White bowel movements are normal.
• After the test, your child can return to normal activities and resume a normal diet.
• Your child should drink plenty of liquids.
• If your child is constipated after the test, he or she may take a mild laxative.
• If your child’s constipation continues, please contact your family doctor or PCP for advice and treatment.
• A report of your child’s barium enema will be sent to the doctor who prescribed it, usually within 48 hours. If the results are urgent, the referring doctor will be contacted immediately.
• Please contact the doctor who prescribed the test for the results.
• If you have any other questions or concerns about the test, please call the Department of Pediatric Radiology and a nurse or X-ray technologist will discuss them with you.

If your child has any special needs or health issues you feel the doctor needs to know about, please call the Department of Pediatric Radiology at Children’s before the test. It is important to notify us in advance about any special needs.

Preparing your child beforehand, as well as comforting your child during the test, will help your child have a more positive experience. Sometimes it is difficult to know how to explain tests to children. If you have any questions about ways to prepare or support your child, or feel your child will have difficulty during the test, please call the Department of Pediatric Radiology at Children’s and ask to speak with the Child Life Specialist.

• Getting a Barium Enema Photo Preparation Book (PDF)
• Getting a Barium Enema Photo Preparation Book (Spanish) (PDF)
• Getting a Barium Enema Photo Preparation Book (Arabic) (PDF)