Cincinnati Children's Blog



Many children have common medical problems that require an X-ray to evaluate their medical issue. One very common medical problem in children is constipation. This refers to a child who stools infrequently enough to collect an abnormally large amount of stool in the large intestine, sometimes causing abdominal pain, and resulting in difficulty eliminating it from their bottom or sometimes even causing them to have accidents in their underwear.  

If stool softeners or other medicines to help them eliminate the stool are not working, oftentimes the pediatrician may order a contrast enema. This is an imaging test that can map out the large intestine to make sure there are no blockages resulting in decreased elimination of the stool.  

The test involves laying the child on an X-ray table and placing a tube that fits into the distal rectum and infusing a clear, water soluble fluid that can be seen when the X-ray are turned on. The images of the large intestine are seen on a video screen. Once the images are taken, the patient is sent to the bathroom to eliminate the fluid and stool in the toilet. An X-ray of the belly is then taken again to see how much stool was eliminated.  

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Image: The pre-evac image shows the entire colon filled with the fluid we can see on X-ray that gives a nice map of the large intestine.

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Image: The post-evac image shows how well the child can evacuate the fluid in the toilet. In this child, a lot was evacuated with only a small amount remaining.

This test can help your doctor know if there is an abnormality that needs to be fixed to help your child stool better.  

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Dr. Steven Kraus, author; Glenn Miñano, BFA, editor; Meredith Towbin, copy editor

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