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Patient Prep & Instruction Manual

Updated May 2006

Hospital of the University of Pennsylvania, Department of Radiology            3400 Spruce Street, Philadelphia, PA 19104

Scheduled Test: SMALL BOWEL ENEMA (ENTEROCLYSIS)

 

When:_____________

Date:_____________

Time:_____________

Where:	Report to Radiology Reception (Ground Floor, Dulles Building). Look for signs to the Radiology reception area where you are to check in. You should arrive at least 30 minutes before your appointment time in order to be registered.
Purpose:	To achieve a fully accurate study of the small bowel by introducing a liquid barium and a water-like substance directly into the upper part of the small intestine.
Preparation:	If you are a woman of childbearing age and there is a chance you may be pregnant, please consult your physician before scheduling this exam. Medications can be taken prior to your test. Pills should be taken with just a small amount of water, early in the morning. If you take insulin, you must consult your doctor about adjusting your dose. You should not take insulin if you are fasting for your exam. However you should bring your insulin with you so you can take it after the exam. Also, when making an appointment, tell the scheduler if you are diabetic and request an appointment time early in the day. The presence of food material in the small bowel and in the right side of the colon will render the examination less accurate. Four Dulcolax® (bisacodyl) tablets are necessary for the preparation and can be purchased at any pharmacy, including the Pharmacy of the Hospital of the University of Pennsylvania. On the day before the examination, ONLY clear liquids may be taken (water, apple juice, cranberry juice, bouillon soup, tea or coffee without milk or sugar, Jell-O). Be sure to drink a sufficient quantity of fluid. At 5:00 PM four bisacodyl tablets (Dulcolax® tablets) should be taken with a glass of water. After 10:00 P.M. NOTHING should be taken by mouth. On the day of the examination: NO food or fluids are allowed. You will be asked to change into a hospital gown. Patients less than 18 years old must be accompanied by a parent or guardian. Please do not bring children with you to the appointment. Be sure that your doctors office has sent an x-ray request form to the department or that you bring one with you
Procedure:	The Examination: You may be given two tablets of Metoclopramide (Reglan) before the examination begins; the purpose is to help the flow of barium through the whole of the small bowel. You will be asked to sit on the side of the x-ray table. The radiologist will spray your throat in order to render its surface insensitive. You will be helped to swallow a soft plastic tube, its diameter slightly larger than spaghetti noodle, You will then lie down on the x-ray table and the tube will be passed through the stomach into the upper portion of your small bowel. To do this, it will be necessary to turn you to one side or the other and apply manual pressure to the outside of the abdomen. The radiographer will introduce barium through the tube and this will be followed by a water-like solution to propel the barium through the whole small gut. A total quantity of one to two liters of fluid will be introduced, and you may experience a feeling of fullness. A number of x-ray images will be taken. At the end of the examination, usually some 15 minutes after the tube has been introduced, the tube will be removed and the radiographer will take one or two further pictures. After the Examination: You will feel an urge to go the bathroom and you will pass much of the fluid that had been introduced. Occasionally it will be necessary for you to return to the x-ray room for a few additional images. The radiologist’s report of the results will be sent to your doctor. Your doctor will discuss the results of the test with you.
After Care:	You should resume your normal diet and drink plenty of fluids. Please call (215) 662-3518 (GI) if you have additional questions.

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