What is a Contrast Enema?
A contrast enema is an imaging study that allows us to examine your child's colon (the large portion of the bowel).
During this exam, we fill the bowel with a liquid contrast agent containing barium or iodine. This will highlight any abnormalities in the colon’s structure.
We will then use a special type of X-ray (fluoroscope) to produce a moving image of your child’s bowel activity.
Your child’s physician may request this test to evaluate:
- Newborns with difficulty producing early bowel movements (meconium)
- Infants who are constipated
- Children who experience bleeding from the rectum
- Children diagnosed with necrotizing enterocolitis (NEC)
- Children who have had bowel surgery
How should I help my child get ready for the test?
Most children won’t need any special preparation for a contrast enema. However, those who have bleeding from the rectum will need to clear the bowel before the exam. These patients will either drink a special liquid or receive a cleansing enema. Your physician will give you full instructions on how to administer this beforehand.
On the day of the test, make sure your child is wearing comfortable clothes. He or she will be asked to change into a gown before the exam.
What happens during the test?
You child will lie on the stomach down, on the exam table. During the test, a large machine called a fluoroscope will pass over the examination table, taking a series of images.
Just before the test begins, we will insert a very small flexible tube into your child’s rectum and begin to fill the bowel with a contrast fluid. Your child may need to turn from side to side or from stomach to back, to assure that this fluid moves throughout the bowel. An even distribution of the contrast fluid allows us to view its size, shape, and contours of the bowel more accurately.
ntours of the bowel more accurately.
During this test, your child may feel mild abdominal cramps, the kind that usually precede a bowel movement. He or she will be instructed to “hold it” until the test is completed. Then we will remove the tube, and your child will be able to get up and go to the bathroom.
The test can be completed within 30 to 60 minutes.
How can I make my child comfortable during the test?
Younger children may find the fluoroscope a bit intimidating. A physician will stay in the room and explain every step of the exam and may also be present to offer comfort and reassurance. If you choose to stay in the exam room, you will be given a lead apron to wear to protect you from unnecessary radiation.
We can also arrange for a child life specialist to there, and to put your child at ease during the procedure.
Are there any risks?
Although this exam uses X-rays, a form of diagnostic radiation, your child will be exposed to minimal doses.
Occasionally children have a mild reaction to the contrast agent, and experience stomach cramps, diarrhea, or constipation. Some children may be allergic to the agent, and develop hives, itching, or red skin. We have medications on hand to counteract their symptoms. While severe allergic reactions are unusual, we are well-prepared to deal with them. In very rare cases, the test may cause a perforation of the bowel. If this occurs, we will repair it immediately with surgery.
What happens after the test?
Your child will be able to resume normal activities right after the test.
A radiologist will analyze the ultrasound images and your child’s doctor will explain the results.