It can feel a bit overwhelming when we, as doctors, mention that your child might need a contrast enema. You’re probably wondering, “What on earth is that?” and “Is it going to be scary for my little one?” I completely understand. Let’s talk it through, just like we would in my clinic. My goal here is to help you feel informed and a little more at ease.
So, What Exactly is a Contrast Enema?
You might also hear this test called a barium enema. Essentially, it’s a special kind of X-ray that helps us get a good look at your child’s colon, which is their large intestine. This isn’t something we can see during a regular check-up, you know?
The test is usually done by a pediatric radiologist. That’s a doctor who specializes in using imaging, like X-rays, for children. They use a technique called fluoroscopy, which is like a moving X-ray. It allows us to see how your child’s colon is shaped and how it’s working in real-time. Pretty neat, huh?
To make the colon show up clearly on the X-ray, we use a safe, chalky liquid called barium (or sometimes another type of contrast material). This liquid is gently introduced into your child’s bottom through a small tube. When the barium coats the inside of the colon, it helps us see all the details.
Why Might My Child Need This Test?
Often, we recommend a contrast enema if your child is having persistent trouble with pooping. It helps us investigate things like:
- Ongoing constipation (difficulty pooping)
- Chronic diarrhea that just won’t go away
- Concerns about a condition called Hirschsprung disease, which affects how the large intestine works from birth
- Unexplained weight loss that we need to get to the bottom of
It’s really a way for us to gather more information when we suspect something might be going on in their lower digestive tract.
The Contrast Enema Procedure: Step-by-Step for Parents
Knowing what to expect can make a big difference for both you and your child. The whole thing usually takes about 30 to 45 minutes.
Getting Ready for the Test
Good news! Most of the time, there’s no special preparation needed. Your child can usually eat and drink normally beforehand, but we’ll always give you specific instructions if anything different is needed.
It’s a wonderful idea to talk to your child about it, in simple terms they can understand. Let them know you’ll be there. Bringing a favorite blanket, a special toy, or a book can be a great comfort.
During the Procedure
You’ll be right there with your child in the X-ray room (we’ll give you a lead apron to wear for safety). If you’re pregnant, though, it’s best to have another trusted adult stay with your child, as we try to limit X-ray exposure during pregnancy.
Here’s generally what happens:
- Your child will change into a hospital gown and lie on an exam table. They’ll be awake the whole time.
- The radiologist will take an initial X-ray of your child’s tummy.
- Then, they’ll ask your child to lie on their side and bring their knees up towards their chest – kind of like a little ball.
- A small, soft tube will be gently inserted into your child’s rectum (their bottom, where poop comes out). The other end of this tube is connected to a bag with the barium liquid. The tube is usually secured with a bit of tape to keep it in place.
- The barium will slowly flow from the bag, through the tube, and into your child’s colon. It’s very common for children to feel like they need to poop at this point. That’s totally normal, and the team is used to it.
- As the barium fills the colon, the radiologist will take X-ray pictures. They might ask your child to roll gently from side to side so they can get views from different angles.
After the Pictures are Taken
Once all the necessary X-rays are done:
- The little tube will be removed.
- Your child will be able to go to the restroom right away to poop out the barium.
- Often, one last X-ray of their tummy is taken after they’ve been to the toilet.
And that’s it! Your little one is a superstar for getting through it.
What to Expect After Your Child’s Contrast Enema
Usually, your child can go back to their normal activities and eating habits straight away. Here are a couple of things to keep in mind:
- Encourage them to drink plenty of fluids. Water is great! This helps flush the remaining barium out of their system.
- Don’t be surprised if their poop looks white or light-colored for a day or two. This is just the barium making its way out and is perfectly normal.
- They might also need to poop a bit more frequently for a few days.
Are There Any Risks or Side Effects?
Contrast enemas are generally very safe procedures, especially for children. The amount of radiation from the X-ray is minimal. Like any medical test, there are small potential risks, but serious complications are rare.
Some children might experience temporary:
- Bloating or a feeling of fullness
- Mild constipation (though sometimes it helps things move!)
- A bit of diarrhea
- A mild headache
- Nausea (feeling like they might throw up)
An allergic reaction to the barium is very uncommon. Extremely rarely, a tiny tear in the bowel (called a gastrointestinal perforation) could occur, but this is a very, very rare event. We always watch closely for any signs of problems.
Understanding the Results and Next Steps
The radiologist will carefully look at all the X-ray images and write a report. This report, along with the images, will be sent to your child’s main doctor (their pediatrician or the specialist who ordered the test). This usually takes a few days.
Your child’s doctor will then discuss the results with you.
- A negative result is good news! It means no issues or abnormalities were seen in your child’s colon.
- A positive result means that the radiologist did see something, perhaps a blockage or another issue. If this is the case, your doctor will explain what was found and what the next steps might be, which could sometimes involve more tests or a specific treatment plan.
When to Call Your Child’s Doctor
After the contrast enema, please give your child’s doctor a call if your little one develops any of these symptoms:
- Abdominal swelling (their tummy looks bigger or feels very hard)
- Any blood in their poop (this is also called rectal bleeding)
- Dizziness
- A fever
- Severe tummy pain that doesn’t go away
- If they are unable to poop for more than two days after the test
Helping Your Child Feel Comfortable
It’s natural for your child (and you!) to feel a bit anxious. Here are a few things I often suggest to parents to help make the experience a little smoother:
- Bring comfort items: A favorite toy, blanket, or stuffed animal can be a real source of security.
- Distraction for older kids: A book or a handheld video game can help pass the time and keep their mind occupied.
- Your presence is key: Stay close, hold their hand, offer reassuring words. Just knowing you’re there makes a huge difference.
- Breathing exercises: Simple deep breaths can be calming. You can practice this together beforehand. “Smell the flower, blow out the candle.”
- Childcare for siblings: If you have other children, try to arrange for someone to look after them so you can focus fully on the child having the procedure.
Key Takeaways About Your Child’s Contrast Enema
This can be a lot to take in, so here are the main points to remember:
- A contrast enema (or barium enema) is a safe X-ray test to look at your child’s colon.
- It’s often used to find out why a child has ongoing tummy or pooping problems, like constipation.
- Your child will be awake, and you can usually stay with them.
- Preparation is typically simple, and recovery is quick.
- Their poop might be white for a couple of days – that’s normal!
- The results will help your doctor understand what’s going on and how best to help your child.
It’s completely normal to have questions. We’re here to answer them. You’re doing a great job looking out for your child’s health, and we’ll work through this together. You’re not alone in this.
