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Barium enema

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is a barium enema?

A Barium enema examination is a series or X-rays taken to show your child's large bowel, colon and rectum, by injecting a white liquid called barium into the bowel.

What is barium?

Barium is a white liquid with a milk shake chalky texture containing radiopaque substance (barium sulphate) which makes the large bowel easier to visualise.

What happens in a barium enema examination?

The barium enema is a test carried out in the Medical Imaging Department at the Children's Hospital at Westmead. In this examination, a series or X-rays are taken of your child's large bowel.

The test is performed in a room with an X-ray table and a large camera above it. The camera is linked to a television screen where an X-ray image of the bowel can be observed.

The doctor / nurse will lie your child on their side while inserting a thin lubricated plastic tube called a catheter into the rectum through the anus and will adhere it in place with medical tape. Your child will feel some discomfort when the catheter is inserted.

After the insertion of the catheter, barium will then be injected into the bowel through the catheter and your child will feel distension in the abdomen. The barium will flow through the large bowel and temporarily coat the inside lining of the colon and rectum. As the bowel fills with barium, loops of black gut will be seen on the television screen, which helps to show the normal bowel contour, patency and position. A series of X-ray's will be taken in different directions.

The pictures are checked and the test is complete.

How to prepare your child for this examination

It is very important that faecal matter is cleaned from the bowel prior to the test in order to obtain an adequate visualisation of the large bowel. Therefore, you should prepare your child by strictly following the instructions given to you. This is usually done by a regime of low residue diet and laxatives. If in doubt, please contact the hospital for advice.

Age	Preparation
0 - 2 years	No preparation.
2 - 4 years	Day before examination Low residue diet for breakfast, lunch and dinner. Senokot granules at night (per child's weight). Clear fluids: No - solid food, no milk and no fizzy drink. Yes - clear iceblocks, jellies and strained clear soups. Day of examination Clear fluids till 4 hours prior to the examination. Then nothing to eat or drink, not even water.
Over 4 years	Day before examination Low residue diet for breakfast, from then on clear fluids only. Senokot granules at night (per child's weight). Day of examination Clear fluids till 4 hours prior to the examination. Then nothing to eat or drink, not even water.

No preparation is required for the child with acute diarrhoea, suspected Hirschsprung's Disease, Intussusception or Proximal and Distal Loopograms.

Children with Meningomyelocele should have two days of a low residue diet and Senokot granules prior to the examination.

Diabetics (INSULIN DEPENDANT): Fast for three hours prior to the examination.

Low residue diet - is food that is easily digested

Foods to Avoid

• Whole grain breads and cereals
• Corn
• Peas
• Fruit
• Fizzy drinks

Foods Allowed

• Rice Bubbles; Cornflakes
• White Bread
• Honey; vegemite; seedless jam
• Meat; chicken; fish; eggs
• Mashed Vegies - potatoes; pumpkin; carrot
• Plain biscuits; sponge cake
• Ice cream; yoghurt (plain)
• Milk

Clear Fluids = no solid food; no milk; no fizzy drinks

Clear Fluids Allowed

• Ice blocks
• Jellies
• Strained clear soups

Senokot Doses

½ teaspoon is required per 5kg, maximum 2 ½ teaspoons per dose.

0 - 5 kg	½ teaspoon
5 - 10 kg	½ - 1 teaspoon
10 - 15 kg	1 - 1 ½ teaspoons
15 - 20 kg	1 ½ - 2 ½ teaspoons
20 - 25 kg	2 - 2 ½ teaspoons
> 25 kg	2 ½ teaspoons

Advice for parents

• Your child will pass whitish stools for a few days after the procedure.
• Ensure that your child has plenty of fluid to drink and eats high fibre foods to flush out the barium from the colon, as the barium may cause constipation.
• Book an appointment to see your referral doctor within a week's time.

• Your child will feel more comfortable if a parent or carer stays with them during the examination.
• Women who are pregnant should not stay in the room while the X-ray is being taken.
• Other children under 18 years can not stay in X-ray room.

The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 3585 - Fax: (02) 9845 3562 http://www.chw.edu.au/ © The Children's Hospital at Westmead 1997-2010.