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A barium enema is a video X-ray that shows how the colon is working. The colon, also called the large intestine, is located below the stomach at the end of the small intestine. Digested food passes through the colon and out of the body through the rectum. 

A barium enema involves taking X-rays while filling the colon with and emptying it of a special liquid called barium. Barium shows up on X-rays, letting doctors see how it moves in and out of the colon. Radiologists (doctors who specialize in imaging) and radiology practitioner assistants (RPAs)  perform colon scans with the assistance of radiologic technologists. A barium enema takes place in the fluoroscopy  exam room with an X-ray machine, a long table and a television screen. We often explain to patients that the X-ray machine is a large camera for taking pictures inside the body. 


Before the Exam

This section provides basic information about preparing for a barium enema exam and what to expect when arriving at Gillette. 

Preparing at Home 

On the day before the test, patients should: 

  • Drink plenty of clear liquids. Clear liquids include water, tea, apple juice and Jell-O. 
  • Avoid solid foods and milk products, such as milk, cheese, ice cream, yogurt and butter 
  • On the day of the test, patients should only have clear fluids and no solid foods or milk products. 

Screening for Possible Pregnancy 

Patients who are pregnant or who believe they could be pregnant should talk to their doctors before having a barium enema exam. Information discussed with a doctor is confidential. In addition, parents or care-givers who are pregnant or believe they might be pregnant shouldn’t be in the room during a barium enema exam. 

Female patients who are 12 and older must have a urine or blood pregnancy test before receiving sedation medicine. 

Using Positive Distractions 

We help our patients relax by creating a soothing environment. We offer positive- distraction technology for patients who have barium enemas. Positive-distraction technology uses lighting, music and video images to help patients relax during procedures and tests. Patients can choose from a variety of themes, such as baby animals or hot-air balloons. 

Giving Sedation Medicine 

We make every effort to help our patients relax by creating a soothing environment. If a patient will be unable to relax or stay still during an imaging exam, sedation medicine might be necessary. Sedation medicine helps patients relax or sleep during procedures and tests. Patients who will have sedation medicine will receive a patient education piece about that.


During the Exam

This section provides basic information about what to expect during a barium enema. 

Getting Into Position  

Patients remove their clothing and put on hospital gowns. We have private changing areas and lockers to store belongings. Once patients are ready, we help them get into the right position on the exam table. 

For a barium enema, patients lie down on their side with their knees bent and pulled up close to the stomach. 

Minimizing Radiation Exposure

Our practice is to perform imaging tests correctly and thoroughly, while exposing patients to the smallest amount of radiation necessary. We’ll cover the parts of the body that don’t need imaging with a protective apron, whenever possible. 


The Exam

Inserting the Enema and Barium 

Once a patient is in the right position, we gently slide the tip of a small rubber-tubed catheter into the anus (the opening of the rectum where bowel movements come out of the body). The tube is connected to a bag filled with barium. Once the tube is in place, we use special tape on the buttocks to help hold it in place. 

The barium will slowly enter the colon through the enema tube. As the colon fills with barium, the patient will feel the urge to have a bowel movement. This is normal. 

Taking the X-ray Images 

We’ll begin taking X-ray pictures as soon as the barium enters the colon and large intestine. The camera will come close to, but not touch, the body. We’ll be able to see the video X-rays on the television screen. 

During the exam, we might ask the patient to roll to the side or onto their stomach so that we can see different parts of the colon. 

When we’re finished taking X-rays, we’ll remove the tape and catheter and the patient can use the bathroom. 

After using the bathroom, patients return to the exam table, and we take an X-ray of the abdominal (belly) area to see if enough of the barium has emptied from the colon.  

Parent/Caregiver Role

The most important thing parents and caregivers can do is to help children stay calm during imaging exams. They can do this by staying calm themselves. 

Often, parents or caregivers can be in the room. In such cases, parents can: 

  • Talk to their children and hold their hands for reassurance. 
  • Calmly encourage their children to take deep breaths. Taking long, deep breaths through the mouth can help children remain calm when we put the catheter tip into the colon and insert the barium.

After the Exam

A barium enema takes about 30 to 45 minutes. The test is finished when we’ve taken all of the pictures we need and have concluded that enough barium has emptied from the colon. 

Follow-up Care 

After a barium enema, patients: 

  • Will be able to go to the bathroom 
  • Can return to normal activities and resume a normal diet 
  • Should drink plenty of liquids 

The barium will cause white bowel movements for a day or two after the test. Some patients also experience constipation (hard stool or difficulty passing stool). Mild laxatives can help. If the constipation continues or is an ongoing problem, contact the primary-care doctor. 

Receiving the Results 

We usually send the results to the doctor within 48 hours. If the results are urgent, we’ll contact the doctor immediately. Questions about the results should be discussed with the doctor. 


For More Information

For more information about imaging tests at Gillette, please call the Advanced Imaging Center at 651-229-3995.

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team. If you are a Gillette patient with urgent questions or concerns, please contact Telehealth Nursing at 651-229-3890.