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Barium Enema – WR Pediatric Imaging Procedure

The preparation needed before a barium enema will depend on which type of enema is ordered. Please note which one has been scheduled and follow the appropriate instructions carefully. Failure to do so may mean that the test cannot be performed. If there are any questions, please call our office at 919-781-6707.

Enema, unprepped (for constipation, or to rule out Hirschsprung’s disease)

Day before the exam: No prep necessary. Nothing in the rectum for 24 hours prior to the exam, including suppositories, enemas, or thermometers. No rectal exams.

Day of the exam: Your child may continue to eat normally. If your child is taking any medicines by mouth, they can still be given.

Enema, prepped (for rectal bleeding or polyps)           

Two days before the exam

It is important that the colon be thoroughly cleaned out. It will be easier to do this if the child is already having a soft bowel movement every day. If this is not happening, give 2 doses of Milk of Magnesia at the following doses:

Age 12 years and older: 2 tablespoons twice a day

6-11 years old: 1 tablespoon twice a day

2-5 years old: 1 teaspoon twice a day

less than 2 years old: consult your physician

Follow the Milk of Magnesia with a glass of liquid (8 oz). Stop giving it if diarrhea occurs. If your child has not had a bowel movement by the next morning, give one dose of the Milk of Magnesia that morning.

One day before the exam

1. Eat a light breakfast by 11:00 AM. After 11:00 AM, the patient may only have CLEAR LIQUIDS for the rest of the day and up until 2 hours before the enema. Clear liquids include drinks like Gatorade, Kool-Aid, sodas and soft drinks (regular only, not diet), clear juices such as apple or white grape juice, water, broth, home-made Jell-O (but NOT the pre-made cups), ice pops without fruit, Italian ice, hard candies, and sweetened tea. Do not use products that are red or purple in color, as this may look like blood during the procedure. Make sure your child drinks LOTS of clear liquids other than water to prevent dehydration and electrolyte imbalance.

2. You will need to purchase 1 or 2 bottles of Magnesium Citrate (10 oz each) for the clean-out. Refrigerate these, as the medicine tastes better cold. Your child will take 3 doses of the Magnesium Citrate at  11:00 AM, 2:00 PM and 5:00 PM.  Each dose is 4 ml per kilogram of body weight with a maximum of 5 oz (150 ml) per dose. This is your child’s dose:_______. Each bottle is 10 oz, so the maximum amount is ½ bottle per dose. This can be flavored with Kool-Aid powder, but be careful not to dilute this too much, as it just increases the volume your child will have to drink.

3. If stools are not watery-clear by evening, please give your child one square of chocolate Ex-Lax the night before the exam. Be sure to keep this out of your child’s reach, as most children like it!

Day of the exam

If your child is taking any medicines by mouth, he or she may take them with a small amount of water.