Preliminary

1. Evaluate preliminary plain radiograph of the abdomen for:

   1. relative contraindications (stool or contrast material in colon)

   2. absolute contraindications to performing a barium enema (i.e., free air, rigid abdomen).

   
   

2. Question the patient about:

   1. relevant symptoms and previous abdominal surgery.

   2. the "three P's" (pregnancy, recent procto, and bowel prep).
      
      

3. Explain the procedure to the patient. Ask if he/she has any questions. Talk to the patient throughout the examination to decrease anxiety and divert attention.
   
   

4. You will be assisted by an aide or technologist who will shake the bag of barium sulfate to produce a uniform suspension, run barium from the enema bag into the plastic tubing to expel the air, and, finally, clamp the tubing. The enema bag will be hung on an I.V. pole and raised not more than 3 feet above the table top. The assistant will then place the patient on his left side, lubricate the enema tip, and insert it into the patient's rectum. (If the aide or technologist encounters any difficulty, the radiologist will be summoned to perform a digital rectal exam and insert the tip.)
   
   

5. Radiographic technique for spot images and overhead radiographs should be set to 125 kVp.