Modifications

1. Modification #1. (To follow Step #4 if barium has not reached the ascending colon.) Turn the patient 360&deg in each direction. When the patient is again prone, take another look. If barium is now in the ascending colon, proceed to Step #5; if not, go to Modification #2. (NOTE: Do not insufflate additional air at this point, as it will likely produce an air-lock in the cecum.)
   
    
2. Modification #2. (To follow a failed Modification #1) Pour one liter of thin (dilute) barium into the enema bag. Use this thin barium as a plunger to push the thicker, double-contrast barium into the ascending colon. After the head of the barium column reaches the ascending colon, return to Step #5, above Then, proceed with the subsequent steps as usual.