Enema

Your child is scheduled for an enema at Children's Hospitals and Clinics of Minnesota.

Date: _____________________________

Test time: _____________________________

Check-in time: _____________________________

___ Children's - Minneapolis
2525 Chicago Avenue South
Minneapolis, Minnesota 55404
612-813-8200

___ Children's - St. Paul
345 North Smith Avenue
St. Paul, Minnesota 55102
651-220-6147

___ Children's - Minnetonka
6050 Clearwater Drive
Minnetonka, Minnesota 55343
952-930-8600

Please bring a list of your child's medicines and your insurance card with you. If you have questions about your insurance coverage for these services, or any special referral requirements, please contact your insurance company directly. They will advise you about your plan's coverage.

A parent or legal guardian must accompany children younger than 18 years old.

If your child is a girl who is 12 years old or older, she will need to have a pregnancy test done before we can begin this exam. Your child will be asked to give a urine sample and a quick pregnancy test will be done at that time by the technologist.

What is an enema?

This test shows how the large intestine is working. The large intestine includes the colon and the rectum (where stool is kept before it comes out). Then a contrast material is put into the colon so the X-ray camera can take images (pictures) of what the colon looks like inside.

How is the test done?

A technologist will take you and your child into an exam room with an imaging bed and a large camera connected to a monitor. Your child will be asked to put on a hospital gown and lie on the imaging bed. You may stand by your child's head to provide support and distraction. An X-ray may be taken of your child's abdomen (belly).

The radiologist or technologist will ask your child to lie on one side and pull his or her knees up close to the abdomen. Next, the technologist or radiologist will insert a soft, flexible tube into the rectum. The tube is lubricated to help it slide in smoothly. Putting the tube in may feel uncomfortable, but this part of the test will be over quickly.

In order to see inside the colon, the radiologist will administer the contrast through the tube into your child's rectum and colon. While watching the monitor, the radiologist will stop and start the flow of barium. To get a better view, the radiologist may push gently on your child's abdomen, or ask your child to change positions. Your child may soon feel a strong urge to have a bowel movement.

Your child will be asked to hold it (not let the contrast out) and take long, deep breaths through the mouth, to help relax. It is important for your child to remain still while the X-rays are taken.

After several X-rays are taken, the tube will be removed and your child can go to the bathroom. After the bowel movement, the technologist will take a few more X-rays.

The radiologist will check the X-rays to see if any more are needed before you leave, and will send a report to your child's doctor.

Can I be with my child during the test?

If not pregnant, you are welcome to stay with your child. You will be given a lead apron to wear.

The exam lasts about 10 minutes. You may need to stay up to an hour after that, depending in part on how long it takes your child to have a bowel movement. If your doctor has ordered sedation for your child, plan on about 1 to 2 hours for the test. See the education sheet, "Nitrous oxide for sedation."

What should we do before the test?

Usually you can maintain your child's routine eating, sleeping, and medicine schedules before the test. Your child's doctor or a Children's staff member will tell you if your child needs any special preparation. There may be different instructions if your child will have sedation or more tests in radiology on the same day.

If your child is scheduled for an air contrast barium enema, call the hospital's radiology department for before-test instructions.

Read and discuss this information with your child. Answer as many questions as you can.

To learn more about preparing and helping your child cope with this test, call the child life department. Child life specialists are trained to help children understand and cope with medical procedures and can offer advice on how to talk with and support your children. There is no charge for child life.

Children's - Minneapolis: 612-813-6259
Children's - St. Paul: 651-220-6465
Children's - Minnetonka: 952-930-8773

How should I prepare my child?

Children are usually less afraid and feel more successful when they know what to expect and what is expected of them. You know your child best. The amount of detail you give will depend on your child's age and developmental level, reactions to previous health care experiences, and degree of anxiety about this test. Talking about it can help your child be more comfortable with the test, which will make the procedure easier for both of you.

Most children benefit when you use simple words to explain:

why the test is needed. For example, "To help find out why you have trouble pooping" (use the words familiar to your child), or "to find out why you're constipated."
which part of your child's body will be involved. For example, "your bottom," or "where your poop comes out" (use the words familiar to your child).
what your child might see, hear, and feel. For example, the camera, touch to private parts, slippery lubricant, urge to have a bowel movement.
that it is okay for staff to touch your child's body, including private parts, for this test.
where parents or other significant care providers will be during the test: "I/we will be with you the whole time."
that questions are welcome at any time.

For many children, a big concern is whether or not the test will hurt. Assure them that although there may be some discomfort, it will only last a few moments. Remind them that the test important because it helps find out how their body is working inside.

How can I support my child during this test?

Before the appointment, you and your child can:

practice lying down and being "as still as a statue."
practice relaxing. Imagine being in a favorite place or doing a favorite activity.
pack comfort items, such as a stuffed toy or blanket, some familiar books or quiet toys, a pacifier for very young children. Older children and teens may want to bring an iPod® or a hand-held video game.
talk about how much your child wants to know about the test while it's happening. Some children want to be told each step in advance and also while it's happening. Others do not want all the detail. They simply want to be distracted and supported. Be sure to share your child's wishes with the staff once you are here.

During the test

Research is clear that parents are most helpful to their children during stressful times when they offer distraction, rather than apologies.

Praise your child often during the test. Be specific to behaviors, such as "You're holding still. Good for you!" or "You're doing just what we asked you to do!"
Talk about familiar, positive things – things your child likes, places you've enjoyed, activities you're planning as a family, fun times you've had, successes.
Imagine the places, things, or people you're talking about and describe them, or have your child describe them to you. Ask open-ended questions that encourage conversation rather than those that require just a yes or no answer. For example, "Tell me what you'd like to do when we go to the pool" works better than, "We're going to have a great time when we go swimming, aren't we?"
Sing songs together. Play games that require thinking, such as spelling words, or adding and subtracting out loud. Ask young children such things as which animals live on a farm or in the zoo and the sounds they make, or to name all the people in their family or class, and so on.
Read the books you brought, hold a toy so your child can see and play with it, play "Can you guess?" and give clues about people and pets you know, things you see in the room.

What can we expect after the test?

After the exam, your child may have an upset stomach. This is normal. Encourage your child to drink plenty of liquids and resume normal activity.

If barium is the contrast used it is important to prevent constipation. Give extra fluids to help pass the barium. See the education sheet, "Barium exam: Care at home."

You will receive the results from the doctor who ordered the test.

What else do we need to know?

You may pre-register online at www.childrensmn.org. Please do this before 3 p.m. the day before the test.

If you prefer, you can call the admitting office the day before the test is scheduled.

Children's - Minneapolis: 612-813-6231
Children's - St. Paul: 651-220-6878
Children's - Minnetonka: 952-930-8600

Pregnant women cannot be in the exam room during the test. A family member or friend, age 18 or older, may stay with your child. Siblings may not be in the room during the test. Please have an adult stay with them in the waiting room, or sign them into the Sibling Play Area (if 2 years or older). Plan to allow extra time before the appointment, to check your children into the Sibling Play Area.

Questions?

This sheet is not specific to your child but provides general information. If you have questions or need more information about the test, call the radiology department at the site checked at the beginning of this sheet.

This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit www.childrensmn.org/educationmaterials.