What is a barium meal test. How is a barium meal test performed. Why is a barium meal examination necessary. What are the risks associated with a barium meal test. How should patients prepare for a barium meal test. What can patients expect after a barium meal test. How does a barium meal test differ from other diagnostic procedures.

Understanding the Barium Meal Test: A Diagnostic Imaging Procedure

A barium meal test, also known as a barium swallow, is a crucial diagnostic imaging procedure used to examine the upper gastrointestinal tract. This test involves the use of a contrast medium, barium sulfate, which allows for clear visualization of the esophagus, stomach, and small intestine on X-ray images.

How does the barium meal test work? The barium sulfate, a radio-opaque substance, coats the lining of the digestive tract, making it visible on X-ray images. This enables radiologists to detect abnormalities and diagnose various conditions affecting the upper gastrointestinal system.

Key Components of a Barium Meal Test

• Barium sulfate: A contrast medium that highlights soft tissues
• X-ray imaging: Used to capture images of the coated digestive tract
• Fluoroscopy: Allows real-time viewing of the barium as it moves through the system
• Carbex granules: Creates gas to expand the stomach for clearer imaging

The Barium Meal Procedure: Step-by-Step Guide

The barium meal test is a carefully orchestrated procedure that requires proper preparation and execution. Understanding the steps involved can help patients feel more comfortable and prepared for the examination.

Pre-Test Preparation

What should patients do before the test? Preparation is crucial for a successful barium meal examination. Patients are typically instructed to:

• Fast for several hours before the test, usually overnight
• Take a laxative the night before to ensure an empty small bowel
• Remove all jewelry, dentures, glasses, and metal objects
• Change into a hospital gown

During the Procedure

The barium meal test is performed by a radiologist or radiographer specializing in diagnostic imaging. The procedure typically follows these steps:

1. The patient is given fizzy carbex granules to create gas and expand the stomach
2. The barium contrast liquid is administered for the patient to drink
3. Initial images are taken to ensure the barium has reached the stomach and small bowel
4. A series of X-ray images are captured over time as the barium moves through the digestive system
5. Additional images may be taken once the barium reaches the large bowel or colon

How long does a barium meal test take? The entire procedure can last anywhere from 1 to 5 hours, depending on how quickly the barium moves through the patient’s digestive system.

Diagnostic Applications: When is a Barium Meal Test Necessary?

Barium meal examinations play a crucial role in diagnosing various gastrointestinal conditions. Healthcare providers may recommend this test to investigate symptoms or confirm suspected disorders affecting the upper digestive tract.

Common Indications for a Barium Meal Test

• Persistent abdominal pain or discomfort
• Difficulty swallowing (dysphagia)
• Unexplained weight loss
• Recurrent nausea or vomiting
• Suspicion of structural abnormalities in the digestive tract

What specific conditions can a barium meal test help diagnose? This imaging procedure is particularly useful in identifying:

• Esophageal strictures or constrictions
• Hiatal hernias
• Gastroesophageal reflux disease (GERD)
• Ulcers in the stomach or duodenum
• Tumors or masses in the upper gastrointestinal tract
• Inflammatory bowel diseases affecting the small intestine

Assessing Risks and Safety Considerations of Barium Meal Tests

While barium meal tests are generally considered safe, it’s essential to understand the potential risks and take necessary precautions. Healthcare providers carefully weigh the benefits against any possible risks before recommending this procedure.

Radiation Exposure

Are barium meal tests safe in terms of radiation exposure? The amount of radiation used in a barium meal test is relatively low, and the associated risks are minimal. However, as with any X-ray procedure, there is a small amount of radiation exposure.

Who should avoid barium meal tests due to radiation concerns?

• Pregnant women or those who may be pregnant
• Individuals who have had multiple recent X-ray procedures
• Patients with known sensitivity to radiation

Barium-Related Risks

Is the barium used in the test safe? Barium sulfate is not absorbed by the body and is generally considered safe. However, there are some potential risks to be aware of:

• Aspiration: In rare cases, patients may accidentally inhale the barium liquid
• Allergic reactions: Though extremely rare, some individuals may be allergic to barium
• Constipation: Barium can cause temporary constipation in some patients

Post-Test Care and Recovery: What to Expect After a Barium Meal

After completing a barium meal test, patients may experience some temporary effects and should follow specific care instructions to ensure a smooth recovery.

Common Post-Test Symptoms

What side effects might patients experience after a barium meal test?

• Abdominal bloating or discomfort
• Constipation
• White or pale stools for a few days

Post-Test Care Instructions

How can patients manage post-test symptoms and promote recovery?

• Drink plenty of fluids to help flush the barium from the system
• Consume a diet rich in fruits and vegetables to prevent constipation
• Consider using mild laxatives if recommended by the healthcare provider
• Report any severe or persistent symptoms to the doctor

Comparing Barium Meal Tests to Other Diagnostic Procedures

While barium meal tests are valuable diagnostic tools, they are not the only option for examining the upper gastrointestinal tract. Understanding how this test compares to other procedures can help patients and healthcare providers make informed decisions about the most appropriate diagnostic approach.

Barium Meal vs. Endoscopy

How does a barium meal test differ from an endoscopy?

• Invasiveness: Barium meal tests are non-invasive, while endoscopies involve inserting a camera into the digestive tract
• Visualization: Endoscopies provide direct visual examination of the digestive lining, while barium meals rely on X-ray imaging
• Biopsy capability: Endoscopies allow for tissue sampling, which is not possible with barium meal tests
• Patient comfort: Barium meals are generally more comfortable for patients compared to endoscopies

Barium Meal vs. CT Scan

What are the key differences between a barium meal test and a CT scan of the abdomen?

• Radiation exposure: CT scans typically involve higher radiation doses than barium meal tests
• Detail level: CT scans can provide more detailed cross-sectional images of all abdominal organs
• Dynamic assessment: Barium meals allow for real-time observation of digestive function, which is not possible with standard CT scans
• Contrast medium: CT scans may use intravenous contrast, while barium meals rely on orally administered barium

Technological Advancements in Barium Meal Testing

The field of diagnostic imaging is constantly evolving, and barium meal tests have benefited from various technological advancements. These improvements have enhanced the accuracy, efficiency, and patient experience of the procedure.

Digital Radiography

How has digital radiography improved barium meal testing?

• Enhanced image quality: Digital systems produce clearer, more detailed images
• Reduced radiation exposure: Digital detectors are more sensitive, requiring less radiation
• Faster image processing: Images are available almost instantly for review
• Easier image storage and sharing: Digital images can be easily archived and transmitted electronically

Advanced Fluoroscopy Systems

What innovations in fluoroscopy have impacted barium meal procedures?

• Pulsed fluoroscopy: Reduces overall radiation exposure by using intermittent X-ray pulses
• Flat-panel detectors: Provide improved image quality and wider dynamic range
• 3D reconstruction capabilities: Allow for more comprehensive visualization of anatomical structures
• Real-time image enhancement: Enables better contrast and detail during the procedure

These technological advancements have not only improved the diagnostic accuracy of barium meal tests but have also enhanced patient safety and comfort during the procedure. As imaging technology continues to evolve, we can expect further refinements in barium meal testing techniques and applications.

Patient Education and Preparation: Ensuring a Successful Barium Meal Test

Proper patient education and preparation are crucial for the success of a barium meal test. Healthcare providers play a vital role in ensuring that patients understand the procedure and are adequately prepared for the examination.

Pre-Test Patient Education

What information should be provided to patients before a barium meal test?

• Explanation of the procedure and its purpose
• Details on fasting requirements and dietary restrictions
• Instructions for taking any prescribed laxatives
• Information about the duration of the test and what to expect during the procedure
• Guidance on clothing and jewelry removal
• Discussion of potential risks and side effects

Special Considerations for Specific Patient Groups

How should preparation be adjusted for patients with specific needs or conditions?

• Diabetic patients: May require special instructions for medication management and fasting
• Patients with mobility issues: May need assistance during the procedure
• Individuals with allergies: Should inform healthcare providers of any known allergies, especially to contrast materials
• Patients with anxiety: May benefit from additional explanation and reassurance about the procedure

By providing comprehensive education and tailored preparation instructions, healthcare providers can help ensure that patients are well-prepared for their barium meal test, leading to more accurate results and a smoother overall experience.

What is a Barium Meal?

Principles of Barium meal

A barium meal is a diagnostic test used to detect abnormalities of the esophagus, stomach and small bowel using X-ray imaging. X-rays can only highlight bone and other radio-opaque tissues and would not usually enable visualization of soft tissue. However, infusion of the contrast medium barium sulfate, a radioopaque salt, coats the lining of the digestive tract, allowing accurate X-ray imaging of this part of the abdomen.

The images produced are fluoroscopic and can be viewed in real-time as well as on plates.

Who can perform a Barium meal test?

A barium meal can be performed by a radiologist (or radiographer) who has specialist skills in imaging studies and works as a healthcare professional to diagnose and treat illness.

Procedure

Before a barium meal test is performed, the duodenum needs to be empty to allow clear visualization of structures. A patient may be given a laxative the night before the procedure to ensure the small bowel is empty at the time of the test, which is usually performed on an empty stomach.

The patient is first asked to change into a hospital gown and remove all jewellery, dentures, glasses, metal objects and clothing as these items can interfere with imaging.

First, some fizzy granules, called carbex granules are given to the patient to create gas and expand the stomach for clearer viewing. Next, the barium contrast liquid is given to the patient to drink.

Some initial images are taken to check that the barium has passed through the esophagus, and into the stomach and small bowel. The radiographer then takes a series of X-ray images over time as the barium contrast moves through the digestive system. This may mean images are taken over anywhere between 1 and 4 hours. Once the barium contrast has passed through to the large bowel or the colon, more pictures are taken. The whole test may take around 5 hours.

Why is this procedure performed?

Barium meal examination is usually performed to help diagnose various diseases or disorders of the digestive system. These include constrictions, hernias, obstructions or masses in the esophagus or stomach, and inflammatory or other diseases of the intestines.

Risks

Exposure to X-rays carries a similar risk as exposure to ionizing radiation. However, the amount of radiation a person is exposed to during an X-ray is is very low and risks are minimal. There are no risks associated with the barium liquid because it is not absorbed by the body.

Some patients, however, are at risk of breathing in or aspirating the barium. X-rays are also harmful to unborn babies and should be avoided by women who are or may be pregnant. Women are asked details of the dates of their last menstruation to ensure the test is performed while the risk of pregnancy is at its lowest.

After the test

Some patients may feel abdominal bloating after a barium meal test and the test may also lead to constipation. Patients are therefore advised to drink plenty of fluid and eat plenty of fruit and vegetables. Mild laxatives may also help. Stools may be pale or whitish for a few days after the test.

References

1. http://www.nationalcapitaldiagnosticimaging.com.au/wp-content/uploads/2010/06/NCDI_018_BariumMeal_PIB-web.pdf
2. http://www.ouh.nhs.uk/patient-guide/leaflets/files%5C100204bariummeal.pdf
3. http://www.guysandstthomas.nhs.uk/resources/patient-information/radiology/Havingabariummealandfollowthrough.pdf
4. http://www.scumj.eg.net/pdf/vol11-n1-2008/19.pdf
5. http://prpimaging.com.au/Assets/Downloadablefile/PRP-Barium-Meal-15253.pdf
6. http://www.liv.ac.uk/HumanAnatomy/phd/mbchb/travel/ba2.html

Further Reading

Video Fluoroscopic Swallowing Exam (VFSE)

A video fluoroscopic swallowing exam (VFSE) looks at your ability to swallow safely and effectively. This noninvasive exam uses fluoroscopy to help identify the thicknesses of liquid and food that you can most safely eat.

Tell your doctor if you are pregnant. List any recent illnesses, medical conditions, medications you’re taking and allergies, especially to contrast materials. This procedure requires little to no special preparation. Your doctor may tell you not to smoke, chew gum, eat or drink several hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may need to wear a gown.

What is a Video Fluoroscopic Swallowing Exam (VFSE)?

A VFSE (modified barium swallow) exam looks at how you swallow different liquids and foods. It uses a special real-time form of x-ray called fluoroscopy. The doctor watches as the patient swallows items with different thicknesses and textures. These items may range from thin barium to barium-coated cookies. A VFSE allows the doctor to test your ability to swallow safely and effectively. A speech-language pathologist also often attends the exam.

An x-ray exam helps doctors diagnose and treat medical conditions. It exposes you to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most often used form of medical imaging.

Fluoroscopy allows your doctor to look at how your tissues and organs look and operate in real time.

Your doctor may use a VFSE just to look at how your muscles move when you swallow. Or, your doctor may perform a VFSE with an esophagram (barium swallow exam. An esophagram looks at how the esophagus looks and operates to the level of the stomach. These two exams have similar names. This can sometimes cause confusion when tests are ordered. Therefore, you should always clarify which exam your doctor wants to order.

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What are some common uses of the procedure?

VFSE is performed on patients with dysphagia, the technical term for difficulty swallowing. The exam is used primarily for looking at how you swallow and any evidence of aspiration. Aspiration occurs when liquid or food goes into the airway (the trachea and bronchi) instead of staying in the pharynx (throat) and esophagus.

A speech-language pathologist may suggest ways to help improve how you swallow. These methods may include tucking or tilting the chin or turning the head while swallowing. The pathologist may also suggest thickening liquids to help prevent aspiration. Your doctor can also use VFSE to see how effective these methods are.

Your doctor may use VFSE because you have a known or suspected problem with swallowing. Or, because you a condition that is strongly associated with swallowing problems, such as:

• coughing and/or choking while eating or drinking
• coughing, choking, or drooling with swallowing
• wet-sounding voice
• changes in breathing when eating or drinking
• frequent respiratory infections
• known or suspected aspiration pneumonia
• masses on the tongue, throat, or larynx
• muscle weakness (myopathy) involving the throat
• neurologic disorders likely to affect swallowing.

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How should I prepare?

Tell your doctor about all the medications you take. List any allergies, especially to iodine contrast materials. Tell your doctor about recent illnesses or other medical conditions.

Other than medications, your doctor may tell you to not eat or drink anything for several hours before your procedure.

Your doctor may also tell you not to smoke or chew gum prior to the exam.

You may need to remove some clothing and/or change into a gown for the exam. Remove jewelry, removable dental appliances, eyeglasses, and any metal objects or clothing that might interfere with the x-ray images.

Women should always tell their doctor and technologist
if they are pregnant. Doctors will not perform many tests during pregnancy to avoid exposing the fetus to radiation. If an x-ray is necessary, the doctor will take precautions to minimize radiation exposure to the baby. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.

Doctors often use VFSE for infants and children. Your doctor will tell you how to prepare your child. You may need to bring small amounts of the foods and liquids your child can eat and drink as well as those they have difficulty swallowing. You may also need to bring the things your child normally uses to eat or drink. These may include the bottles and nipples you use at home, sipper (“sippy”) cups, and/or eating utensils.

The food you bring will be mixed with barium to show up on the x-ray. Explain to your child that barium may change the way the food looks and tastes.

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What does the equipment look like?

This exam typically uses a radiographic table, one or two x-ray tubes, and a video monitor. Fluoroscopy converts x-rays into video images. Doctors use it to watch and guide procedures. The x-ray machine and a detector suspended over the exam table produce the video.

During VFSE, the patient usually sits or stands upright in front or to the side of the x-ray camera.

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How does the procedure work?

X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.

Fluoroscopy uses a continuous or pulsed x-ray beam to create images and project them onto a video monitor. Your exam may use a contrast material to clearly define the area of interest. Fluoroscopy allows your doctor to view joints or internal organs in motion. The exam also captures still images or movies and stores them electronically on a computer.

Your doctor may record your exam to review the images later.

Most x-ray images are electronically stored digital files. Your doctor can easily access these stored images to diagnose and manage your condition.

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How is the procedure performed?

Your doctor and/or speech-language pathologist will take your medical history, including any complaints of problems with swallowing.

The radiologist or technologist and pathologist will guide you through the exam.

You will sit upright on a chair or stool or stand on a platform. If necessary, you may remain in a wheelchair. Infants and children sit in secure seats.

You will eat and drink controlled amounts of foods and liquids in different thicknesses that have been mixed with barium contrast material. The pathologist may try to help you swallow better by changing cups, utensils, or your body position.

As you eat and drink, the doctor will move the x-ray camera near your throat. The pathologist and radiologist will watch you swallow in real time using a fluoroscope. The images are usually digitally recorded so your doctor can review them later.

The imaging part of this procedure usually takes about 15 minutes.

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What will I experience during and after the procedure?

You may find the taste and consistency of the barium unpleasant.

After the exam, resume your usual diet and take oral medications unless told otherwise by your doctor. You may also resume your normal activities.

The barium may make your bowel movements look white for a day or two after your exam. This is normal. Sometimes the barium can cause temporary constipation. You can treat this with an over-the-counter laxative.

Drinking more fluids for several days after the test can also help. Call your doctor if you are unable to have a bowel movement, or if your bowel habits change significantly after the exam.

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Who interprets the results and how do I get them?

Speech-language pathologists and radiologists will review your exam. A report of the results will also be sent to the doctor who ordered the test. The pathologist may meet with you later to discuss your results.

A radiologist, a doctor trained to supervise and interpret radiology examinations, will analyze the images. The radiologist will send a signed report to your primary care or referring physician who will discuss the results with you.

You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.

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What are the benefits vs. risks?

Benefits

• VFSE is noninvasive.
• Allergic reactions to barium are extremely rare.
• VFSE can help determine the consistencies of food that you can most safely eat. This can limit your risk of liquid and/or food entering the airway and lungs (aspiration).
• No radiation stays in your body after an x-ray exam.
• X-rays usually have no side effects in the typical diagnostic range for this exam.

Risks

• There is always a slight chance of cancer from excessive exposure to radiation. However, given the small amount of radiation used in medical imaging, the benefit of an accurate diagnosis far outweighs the associated risk.
• The radiation dose for this procedure varies. See the Radiation Dose in X-Ray and CT Exams page for more information.
• Sometimes, patients are allergic to a flavoring added to the barium. Tell your doctor and the technologist before the procedure if you are allergic to chocolate, certain berries, or citrus fruit.
• You may accidentally aspirate the barium into your lungs during the exam. This does not cause any permanent damage. However, barium might be seen on future images.
• There is a small chance that barium could stay in the gastrointestinal tract. This may lead to a blockage. Patients who have a known blockage should not have this exam.
• Women should always tell their doctor and x-ray technologist if they are pregnant. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.

A Word About Minimizing Radiation Exposure

Doctors take special care during x-ray exams to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection organizations continually review and update the technique standards radiology professionals use.

Modern x-ray systems minimize stray (scatter) radiation by using controlled x-ray beams and dose control methods. This ensures that the areas of your body not being imaged receive minimal radiation exposure.

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What are the limitations of VFSE?

A VFSE only evaluates the area from the back of the mouth through the throat to the top of the chest. Sometimes, your symptoms are due to problems in the esophagus, which is lower in the chest. If so, your doctor may perform an esophagram (barium swallow exam).

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This page was reviewed on November, 15, 2019

Barium swallow and barium meal tests

Both a barium swallow and a barium meal test involve you swallowing a liquid suspension of barium sulphate before a series of X-rays are taken of your upper digestive tract. In a barium swallow test, X-ray images are taken of your pharynx (throat) and your oesophagus (the passageway that connects your throat to your stomach; sometimes called your gullet).

In a barium meal test, X-ray images are taken of your stomach and the beginning of your duodenum (the beginning of your small intestine, the passageway that takes food away from your stomach). A barium meal test is often performed straight after a barium swallow test.

Barium is a naturally occurring element that appears white on X-ray. In these tests, the barium is given as a cup of flavoured drink — like a milkshake. When swallowed, barium coats the walls of the digestive tract, which allows the shape of your upper digestive tract to be outlined on an X-ray. Without the barium your upper digestive tract would be barely visible on X-ray.

Why is a barium swallow or barium meal done?

A barium swallow test may be suggested if you are having difficulty swallowing, or if you have chest pain or reflux (backflow of stomach juices into the lower part of the oesophagus).

A barium meal test may also be suggested if you are having these problems, or if you are having unexplained vomiting, pain in your abdomen, severe indigestion or blood in your stool (which may be coming from your stomach or duodenum or elsewhere in your digestive system).

Barium swallow and barium meal tests help doctors to diagnose inflammation, ulcers or tumours in the oesophagus, stomach or duodenum.

How do I prepare for a barium swallow or barium meal?

So that your upper digestive tract is empty for the test, you will be advised to have no food or drink for several hours before the test. Often this means no food or drink from midnight on the day before a morning test. (Fasting instructions may vary slightly among X-ray centres, so remember to follow exactly the particular instructions that you are given.) If you have diabetes, contact the centre performing the test, or your doctor, about how to prepare for the test.

You may be asked not to smoke for several hours before the test, as smoking causes extra secretions to flow into your digestive tract.

Your doctor will usually advise you not to take your regular oral medicines on the day of the test, until after the test is finished. However, check with your doctor whether this applies to all your regular medicines. It is especially important not to take antacids before the test.

What type of images are produced?

The images produced during a barium swallow and meal test are either moving X-ray images or still X-ray images. Moving images are viewed by a radiologist on a screen and are useful for observing digestive functions such as swallowing and fluid outflow from the stomach. Still images are viewed by a radiologist on an X-ray film and are useful for detecting abnormalities in the wall of the digestive tract such as ulcers or tumours.

What happens during a barium swallow or barium meal?

You will usually go to a radiology or imaging centre, or sometimes to the radiology department of a hospital, to have the barium swallow or barium meal test performed. You will be asked to change from your clothes into a simple gown so that folds of clothing and metal fasteners, for example, do not interfere with producing clear X-ray images.

In the X-ray room you will be told when and how fast to drink the barium solution, usually about one cup in total. If X-rays are to be taken of your stomach (a barium meal test), you may also be asked to drink a small amount of one or 2 other liquids. These liquids combine to produce a gas that expands your stomach, making it easier to detect any abnormalities in its lining. This can make you feel a little ‘gassy’, but you will be asked to resist the urge to burp so that the gas remains in your stomach until after the X-rays have been taken. Doctors call this type of barium meal a ‘double contrast study’.

Sometimes you may also be given an injection of a muscle relaxing medicine to slow the natural movement of the digestive tract. This helps to produce clear X-ray images. If you have glaucoma, you must tell the staff before the test, as a different injection will need to be used.

The first X-rays will be taken while you are standing, usually against a flat panel, with X-ray equipment opposite. As you swallow, the radiologist will watch on a screen moving images of the barium passing from your throat and down your oesophagus. Still X-rays will also be taken to show the barium outlining your digestive tract — you will be asked to hold your breath for a short time when these still X-rays are taken to ensure that clear images are obtained.

After the standing pictures are taken, you will be asked to lie on a table while further X-rays are taken of your oesophagus, stomach and small intestine. You will be asked to roll to various positions on the table so that the barium coats all areas of the upper digestive tract wall. Again you will be asked to remain still and hold your breath for short periods while still X-rays are taken.

A barium swallow and/or meal test is likely to be finished within 30 minutes. The images are checked and only if some images are blurred or further angles are required will additional X-rays be taken.

Occasionally, your doctor may require additional ‘follow through’ X-rays to track the movement of the barium through the small bowel. This may take between one and 4 hours, depending on how quickly the fluid moves through your digestive tract.

What happens after a barium swallow or barium meal?

After the X-rays have been taken and checked to make sure they are clear, a radiologist will view the images in detail and will write a report of their findings for your doctor. You will need to make a follow-up appointment with your doctor to discuss the test results.

After the test you can resume eating normal food. Barium is likely to cause constipation, so you should eat high-fibre foods such as fruit and vegetables and drink plenty of liquids. Your stools will be a whitish colour for 2 or 3 days after consuming the barium. If you experience problems with constipation in the days following the barium test, contact your doctor.

What are the risks of barium swallow or barium meal?

These are safe tests, with a relatively low level of radiation exposure. However, a barium swallow or meal test is not suitable for pregnant women or people with some conditions of the digestive tract, including suspected perforation (a hole in the gut wall) or obstruction (blockage).

Some people experience temporary stomach upset, headache or dizziness after a barium meal or swallow. More serious reactions to the barium are possible but rare — contact your doctor if you experience any symptoms that are unusual for you after a barium meal or swallow.

If a muscle relaxant is used it can cause blurred vision for a short time so you may not be able to drive home straight away.

1. Patient. Barium tests. (reviewed Nov 2015). Accessed at: https://patient.info/health/acid-reflux-and-oesophagitis/barium-tests-swallow-meal-follow-through
2. Radiological Society of North America. RadiologyInfo.org. X-ray (radiography) – upper GI tract. (updated April 2017). https://www.radiologyinfo.org/en/info.cfm?pg=uppergi

Barium Swallow Test – Transplant Procedure

What Is a Barium Swallow Procedure?

A barium swallow is a diagnostic test that involves a series of X-rays of the esophagus, stomach, and duodenum during and after drinking a barium solution. The duodenum is the first part of the small intestine; and the esophagus, stomach, and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system. You may also hear doctors refer to a barium swallow as an “upper GI series” or a “barium meal”.

Parts of the Body Involved

• Esophagus
• Stomach
• Duodenum

Why Does My Child Need a Barium Swallow?

A doctor may order a barium swallow when his or her patient suffers from one of more of the following symptoms:

• Diarrhea
• Weight loss
• Abdominal pain
• Difficulty swallowing
• Regurgitation (vomiting)
• Rectal bleeding
• Bloody stools (bowel movements) or black, tarry stools
• Bloody vomit, or vomit with a “coffee-ground” consistency

A barium swallow can help detect:

• An ulcer
• A blockage
• An abnormal growth or tumor
• Diverticula – an abnormal pouch or sac opening from a hollow organ, such as the intestine
• Gastroesophageal reflux disease (GERD)
• A hiatal hernia
• Crohn’s disease
• Pulmonary aspiration – inhalation of fluid, food, or other foreign matter into the lungs
• Inflammation of the stomach or small intestine

What Is It Like to Have a Barium Swallow?

Prior to the barium swallow procedure

• Review your child’s medications with your doctor. There are some that your child may need to stop taking before the barium swallow procedure.
• For at least eight hours before the test, your child may not eat or drink. Smokers who are about to have a barium swallow should also refrain from smoking during that eight-hour period.
• Your child may be given a medication called glucagon to slow down the activity of the stomach and small intestine.
• Your child may be asked to swallow baking soda crystals. These will bubble and produce gas in his or her stomach, allowing for more detailed X-rays.
• If your child is going to have a small bowel follow-through, you may need to give your child a laxative medication the day before his or her exam, in order to clean out the small intestine. Check with your doctor.

During the barium swallow procedure

Your child will need to remove any jewelry, and change into a hospital gown. He or she will then drink a barium sulfate solution. This is a thick, white, chalky milkshake-like liquid that coats the inside lining of the esophagus, stomach, and duodenum.

As your child drinks the barium, a radiologist takes X-rays of the upper GI area, using a machine called a fluoroscope. If the doctor wants to examine the esophagus, he or she may have pictures taken as your child actually swallows the liquid or small bits of food that are covered with barium. Your child will be asked to change positions frequently in order to coat the entire surface of the GI tract with barium.

If the radiologist wants to examine more of the small intestine, a small bowel follow-through may be done. For this exam, X-ray pictures are taken every 15–30 minutes while the barium travels through the intestine.

There is usually no pain associated with the procedure, so anesthesia is not given. Some people dislike the taste of barium, while others are not bothered by it. A barium swallow can take between 30 minutes and two hours. A small bowel follow-through can take one to four hours.

After the barium swallow procedure

Your child may eat and drink as usual after his or her barium swallow. Unless your child is an inpatient at the hospital for another reason, there is no hospital stay involved.

Have your child drink lots of fluids to eliminate the barium from his or her system.

Are There Complications Associated with a Barium Swallow?

There are a few possible complications your child may encounter following a barium swallow test:

• Constipation for a few days after the barium swallow
• White stool (bowel movements)
• Bowel obstruction (rare)
• Breathing some of the barium into the lungs while trying to swallow it, which can lead to pneumonia

Certain factors increase your child’s risk of experiencing complications during or after the test:

• Presence of food in the stomach
• Presence of barium in the colon
• Perforated or obstructed bowel

Due to risks of radiation exposure from the X-rays, women who are pregnant should not have a barium swallow.

What Happens Next?

A normal barium swallow will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on a barium swallow include obstructions, ulcers of the esophagus, stomach or small intestine, or irregularities in the swallowing mechanism. Your child’s doctor will make treatment recommendations based on the findings.

My Child Is Not Feeling Well After the Barium Swallow. Should I Call the Doctor?

Be sure to contact your child’s doctor if your child experiences any of the following:

• Abdominal pain or bloating
• Constipation doesn’t resolve within a few days
• Signs of infection, including fever and chills

Learn about other Intestine Transplant Tests.

Purpose, Procedure, Risks, Recovery, Results

What Is a Barium Enema?

A Barium enema is an examination of your lower gastrointestinal tract (your doctor may call it your lower GI tract) using X-rays. It’s also known as a colon X-ray.

X-rays show doctors what’s happening inside your body. They produce helpful images of your bones, fat, muscle, and even the air in your lungs. But when it comes to your colon, X-rays aren’t as clear. A barium enema helps get the best detail possible.

Barium is a white, chalky powder. A technician mixes it with water and passes it through a small tube in your rectum. This barium mixture covers the lining of your colon and lets your doctor take images of it at work, highlighting anything that may be causing trouble.

Why Would I Have a Barium Enema?

If you’re having any of these issues, a barium enema can help your doctor narrow down the cause:

A barium enema can also help diagnose conditions from your rectum to your small intestine. These include:

Barium Enema Risks

Because X-rays of any kind may harm a baby in the womb, pregnant women usually don’t get them.

Though the amount of radiation you get is low, too much radiation from X-rays can cause cancer. But it takes years for this to happen, and the chance of getting cancer is small when compared to the benefit of how easily a barium enema can diagnose a problem.

In rare cases, barium enemas can cause complications like:

How Do I Prepare for a Barium Enema?

To get the best images, your colon needs to be completely empty. Anything left in it might be considered part of the problem.

Your doctor will give you specific instructions before the test. Follow them carefully. Make sure it’s OK to take your regular medications and supplements.

Here’s what you can expect:

• A special diet. The day before the exam, you may be asked to steer clear of all solid food and drink clear liquids only, such as broth and tea.
• Nothing after midnight. This is called fasting. Prepare to stop eating and drinking at midnight before the exam.
• Take a laxative. The night before your exam, you may be asked to take a laxative in pill or liquid form to empty your colon.
• Colon cleansing. Your doctor may suggest you use an enema kit, which has a solution that cleans all residue from your colon.

As is the case with other X-rays, you may be asked to take off any jewelry, metal objects, eyeglasses, and dental devices that could alter the images.

What Happens During a Barium Enema?

Usually, a barium enema is done as an outpatient procedure, which means you go in for the test and go back home the same day.

Since you aren’t able to eat or drink before the test, most doctors give barium enemas in the morning. The test can take anywhere from a half-hour to an hour.

Two people will guide you through the barium enema: the radiology technician and a radiologist, a doctor who’s trained to perform and read the X-rays. Here’s how it works:

• You’ll lie on your side on a table and have an X-ray to make sure your colon is completely clean.
• The technician will guide an enema into your rectum. The enema bag holds the barium liquid. Near the tip of the tube is a balloon that keeps the barium inside your body.
• As the barium flows into your colon, you may feel cramping or the urge to have a bowel movement. This can be uncomfortable. Try to breathe and relax so the tube stays in place. You don’t want the barium to leak out. If needed, you can get a bedpan or go to a bathroom.
• They may pump air in to help the barium cover every part of your colon.
• The radiologist may ask you to hold your breath and turn different ways so they can take images from various angles. The radiologist may also press on your stomach area to move your colon into a better position for X-rays.
• Once the radiologist is finished, some of the barium will flow back through the tube into the bag. You can release the rest of the barium, and the air, in the restroom.

What Happens After a Barium Enema?

You may get a laxative or an enema to make sure all the barium is out of your body. You should be able to eat and drink normally afterward. You may have white bowel movements as the barium works its way out of your system.

Call your doctor if you feel constipated, don’t have a bowel movement for 2 days after the exam, or are having a hard time passing gas from your rear end.

Barium Enema Results

The radiologist will examine your images and send a report to your doctor. There are two kinds of results:

• A positive result means the radiologist found something abnormal in your colon.
• Anegative result means your colon is working normally.

If you have a positive result, expect to have more tests, like a colonoscopy, that will either look deeper into the issue, monitor it for change, biopsy an area, or remove a growth.

Barium Enema

Overview

What is barium enema?

Barium enema is an X-ray examination of the rectum and colon. It is also called a lower gastrointestinal tract radiography. The study is performed by pouring contrast (liquid containing barium sulfate) through a tube inserted into the anus. This liquid coats the inside of the large intestine and clearly shows its outline on an X-ray image. These pictures help the doctor to detect abnormalities of the colon.

Why is barium enema done?

A barium enema helps a doctor to see the shape, lining and size of the colon and rectum. Your physician may request that you have a barium enema to assess symptoms, such as the following:

The exam may diagnose diseases, including:

Test Details

What should I expect before the barium enema?

If you are pregnant, might be pregnant or breast-feeding, you need to tell your doctor before the barium enema test is done. When scheduling the test, your doctor will ask you what medications you take and about any potential allergies. The doctor will let you know which medications you can take the day before and morning of the test. In addition, you will need to purchase a 10-ounce bottle of magnesium citrate, Dulcolax® tablets and a Dulcolax suppository.

The day before the test you will not be allowed to eat solid foods or drink dairy. You will only be allowed to have the following:

• Water
• Clear broth
• Clear fruit juices without pulp (apple, white grape, lemonade)
• Clear drinks (clear soda, sports drinks)
• Coffee or tea (do not use milk, cream, or non-dairy creamer)
• Plain Jell-O (no added fruit or toppings)
• Popsicles

The doctor will also give you instructions about how many ounces of water to drink throughout the day. Also, the doctor will tell you when to drink the magnesium citrate and when to take the Dulcolax tablets and suppository.

What should I expect during the barium enema?

• The barium enema test takes around an hour to complete. You will remove clothing and jewelry and put on a gown prior to the study.
• You will lie on your side on an X-ray table beneath an X-ray machine. A tube is inserted into your rectum. The barium will slowly flow through the tube into your colon. If your physician has requested a double contrast study, a small amount of air will also be delivered through the tube.
• X-rays are taken and you may be asked to hold your breath a few times. You may feel abdominal pressure or cramping. You may also feel the need to have a bowel movement. It is important that you resist the urge and you will be given a bed pan or assisted to the bathroom at the appropriate time.
• You will be asked to turn from side to side and hold different positions as X-rays are taken. Also, the exam table may be raised and tilted to spread the barium through the colon. When the radiologist is sure the necessary images have been obtained, the tube is removed.
• You will be taken to the bathroom to empty the barium from your colon, and a final X-ray may be taken.

What should I expect after the barium enema?

After the test, drink plenty of fluids and eat high fiber foods such as whole grains, vegetables or fruits to expel the remaining barium in your colon. You may also take a mild laxative as needed. Your stool may be light in color for a couple of days due to the barium. You can return to normal activities after the examination.

Results and Follow-Up

What do the test results from a barium enema mean?

The X-ray images will be examined by a radiologist and a report will be sent to your doctor. The results will be discussed with you at a later appointment. Based on the findings, your doctor may recommend additional testing or treatment.

What are the risks to a barium enema?

This is a minimally invasive test with few complications. Rare complications include the following:

• Colon perforation
• Severe constipation (impaction) or obstruction from residual barium that hardens
• Allergic reaction to barium

When should I call the doctor after the barium enema?

Call your doctor if you experience any of the following:

• Inability to have a bowel movement or pass gas within two days of the exam
• Severe belly pain or distention
• Rectal bleeding
• Fever

Barium enema – NHS

A barium enema is a test that helps to highlight the large bowel so it can be clearly seen on an X-ray.

During the test, a white liquid called barium is passed into your bowel through your bottom.

A barium enema may be requested by any doctor who thinks you might have a problem with your bowel, including your GP.

The test will usually be carried out at a hospital radiology department by a radiologist or radiographer.

When barium enemas are used

Nowadays, barium enemas aren’t carried out very often, as alternative tests such as a colonoscopy or CT scan are usually preferred.

But a barium enema can sometimes be a useful way of finding the cause of problems like blood in your stools or a constant change in your bowel habits.

Conditions that can be detected during a barium enema include:

Preparing for a barium enema

To ensure the X-ray images taken during a barium enema are clear, your bowel must be empty before the test.

The hospital should send you instructions on what you need to do to prepare.

You’ll normally be asked to:

• eat a light diet – for a few days leading up to the test, only eat low-fibre foods such as clear soup, white bread and lean meat
• take laxative medication – you’ll be given medication that makes you empty your bowels frequently to take from the day before the test
• drink plenty of fluids – this will help to replace the fluids you lose each time you empty your bowels

It’s usually a good idea to stay at home the day before the test, as the laxative medication will make you go to the toilet frequently.

Contact the hospital as soon as you receive your appointment letter if you have diabetes or are pregnant (or think you could be pregnant).

Barium enemas aren’t done during pregnancy because the X-rays may harm the baby.

If you have diabetes, you’ll need to follow special instructions to ensure your blood sugar level is kept under control.

Having a barium enema

When you arrive at hospital, you’ll be asked to change into a hospital gown.

You can take someone with you to the hospital, but they’re not usually allowed into the X-ray room.

During the test:

• you’ll be asked to lie on your side on an X-ray table, and an injection of a medication called Buscopan may be given into your arm or hand to prevent involuntary bowel movements
• a small, soft tube will be gently inserted a few centimetres into your bottom, where it will remain throughout the test
• the barium is passed through the tube and into your bowel – try to keep the muscles in your bottom tight to prevent it coming back out, but don’t worry if some leaks out 
• you may be asked to move around a bit to help the barium spread along your bowel, and air may be pumped into your bowel to expand it and help push the barium around
• several X-rays will be taken with you in different positions

The whole process usually takes around 30 to 45 minutes.

What happens after a barium enema

When the test is finished, the tube will be removed from your bottom and you can go to the toilet to empty your bowels.

You should be able to go home shortly afterwards, although it’s a good idea to take things easy for a few hours before returning to your normal activities.

If you had a Buscopan injection, your vision may be blurry for 30 to 60 minutes, so you won’t be able to drive during this time. It’s best to arrange for someone to drive you home.

When you get home:

• stay close to a toilet for the next few hours, as you may find you need to empty your bowels quite often at first
• your poo may be a whitish colour for a few days – this is normal and is just the remaining barium passing out of your body
• you can eat and drink as normal – drink plenty of fluids and eat high-fibre foods for the first few days to help stop the barium causing constipation

The X-ray images taken during the test will be analysed by a specialist. A report will be sent to the doctor who referred you for the test and you can discuss the results at your next appointment.

Does a barium enema hurt?

Having a barium enema may be a bit embarrassing and unpleasant, but it shouldn’t be painful.

You’ll probably feel uncomfortable when the air is pumped into your bowel during the test, similar to the feeling of having trapped wind.

You may have some bloating, wind or stomach cramps for a short while afterwards.

Are there any risks or side effects?

A barium enema is generally a very safe procedure, although there a few risks and side effects that you should be aware of.

These include:

• laxative side effects – side effects such as feeling sick, a mild headache and bloating are common, but shouldn’t last long
• barium side effects – barium is usually harmless, but it can cause an upset stomach or constipation, and can cause an allergic reaction in very rare cases
• radiation exposure – you’ll be exposed to a small amount of radiation during the test; this is about the equivalent to what you would receive naturally from the environment over 3 years (for more information, see GOV.UK: patient dose information)
• bowel perforation – there’s a risk of a small hole developing in your bowel as a result of the procedure, but this is very rare

Your doctor can help you weigh up the risks of the procedure against the benefits of identifying any problem in your bowel.

Page last reviewed: 16 August 2018
Next review due: 16 August 2021

90,000 What is Barium Meal?

Barium meal, also known as the upper gastrointestinal (GI) series, is a medical test for imaging the upper gastrointestinal tract. This test usually gives x-ray images of the esophagus, stomach, and the first part of the small intestine, known as the duodenum. During the barium test, the patient usually swallows the barium fluid, which appears very clearly on the x-ray and improves the quality of images from the upper gastrointestinal tract.

Doctors may ask patients to take a barium meal test to help diagnose one or more diseases. Some x-rays taken with barium meal show abnormal growths, ulcers, and abnormal narrowing of the upper digestive tract. In some cases, enlarged veins in the esophagus and esophageal hernias may be visible on radiographs that are highlighted with barium fluid. Tumors and muscle abnormalities in the esophagus, stomach, or duodenum can be identified using the upper GI series.

Some doctors order a barium meal x-ray for patients who have symptoms suggestive of an upper gastrointestinal tract disorder. People with nausea, vomiting, and abdominal pain may benefit from upper gastrointestinal x-rays. Individuals with swallowing problems and unusual weight loss are also exposed to the gastrointestinal tract in some cases. Gastrointestinal reflux is a condition that typically causes digestive juices to enter the patient’s esophagus, where they can cause tissue damage that can be detected by the upper GI tract.

While taking barium, the patient usually stands in front of the X-ray machine and swallows a chalky-tasting barium solution that coats the inside of the patient’s upper digestive tract. The patient then lies down in most cases on the X-ray table and the radiologist or technologist takes several X-rays of the upper GI. The patient may be asked to reposition the patient several times during the test in order to obtain x-ray images from different angles.Some patients consume barium solution, which contains gas-forming crystals that evaporate and dilate the digestive tract to provide a better image. Patients can resume their normal diet after gastrointestinal tract in most cases, and they usually skip barium solution in their stools for several days after the test.

In rare cases, patients may develop constipation or bowel obstruction from the barium solution used in the barium meal test.Patients who consume a lot of fluids after the test usually have a lower risk of developing intestinal obstruction or constipation. Allergic reactions to barium solution can occur, which are usually treated with antihistamines. Patients develop symptoms such as abdominal pain or fever on rare occasions after ingestion of barium. Many patients may find it helpful to discuss unusual symptoms or side effects with their doctors.

OTHER LANGUAGES

Upper gastrointestinal row

For the barium meal dough in espionage, seeCanary.

An upper gastrointestinal tract , also called barium meal , is a series of radiographs used to examine the gastrointestinal tract for abnormalities.A contrast agent, usually a radiopaque agent such as barium sulfate mixed with water, is swallowed or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of areas of interest. Barium improves the visibility of the relevant parts of the gastrointestinal tract by coating the inner wall of the tract and making it white on film. This, in combination with other plain radiographs, allows the visualization of parts of the upper gastrointestinal tract, such as the pharynx, larynx, esophagus, stomach, and small intestine, so that the inner wall lining, size, shape, contour and patency are visible to the examiner.With fluoroscopy, it is also possible to visualize the functional movement of the organs being examined, such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be divided into “barium swallow”, “barium meal”, “barium follow-up” and “enteroclitic” (“thin enema”). To further improve image quality, air or gas is sometimes injected into the gastrointestinal tract in addition to barium, a procedure called dual contrast imaging.In this case, the gas is called negative contrast agent. Typically, images obtained with barium contrast are taken with plain x-rays, but computed tomography is also used in combination with barium contrast, in which case the procedure is called CT enterography. ^[1]

Types

Examination of barium meal: stomach and duodenum by double contrast with CO2 as negative contrast agent Barium shows the small intestine with double contrast Enteroclysis for stenosis of the small intestine

Various types of X-ray studies with barium are used to study different parts of the gastrointestinal tract.These include barium swallowing, barium meal, subsequent barium treatment, and barium enema. ^[2] Swallowing barium, barium meal and barium follow-up together is also called the upper gastrointestinal cycle (or study), while the barium enema is called the lower gastrointestinal line (or study). ^[3] For upper gastrointestinal tract examinations, barium sulfate is mixed with water and swallowed orally, whereas for lower gastrointestinal tract examinations (barium enema), barium contrast agent is administered as an enema through a small tube inserted into the rectum. ^[2]

• X-ray examination of the pharynx with barium is used to examine the pharynx. ^[4] and the esophagus. ^[2]
• Barium Food Examination is used to examine the lower esophagus, stomach and duodenum. ^[2]
• Barium cross-sectional examinations are used for examining the small intestine. ^[2]
• Small bowel enteroclysmis is a barium x-ray used to visualize individual loops of the small intestine by intubating the jejunum and administering barium sulfate followed by methylcellulose or air. ^[5]
• Barium enema is used for examination of the colon and rectum and is classified as lower gastrointestinal row . ^[2]

Medical use

Barium X-rays are useful tools for examining the appearance and function of the gastrointestinal tract. They are used to diagnose and monitor esophageal reflux, dysphagia, hiatal hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varicose veins, ulcers, tumors, impaired gastrointestinal motility, and to identify foreign bodies. ^{[3] [6]} Although barium X-rays are increasingly being replaced by more modern techniques such as computed tomography, magnetic resonance imaging, ultrasound imaging, endoscopy and capsule endoscopy, ^[7] barium contrast imaging remains widespread used because it offers the advantages of greater accessibility, greater accessibility, ^{[1] [5]} and better resolution in assessing superficial mucosal lesions. ^{[7] [8]}

Mechanism

Barium sulphate is swallowed, which is because it is a radio-opaque contrast agent that does not transmit X-rays. As a result, areas covered with barium sulfate will appear white on X-ray film. The passage of barium through the gastrointestinal tract is observed by a radiologist using a fluoroscope attached to the TV. The radiologist takes a series of individual X-rays at regular intervals depending on the areas being examined.Sometimes drugs are given along with barium sulfate to release gas in the gastrointestinal tract. This gas expands the lumen of the gastrointestinal tract, providing a better imaging environment, in which case the procedure is called double contrast. ^[9]

Procedure

Clinical status and related medical history are reviewed prior to testing. ^[10] Patient consent is required. ^[3]

Barium swallow

When studying only the larynx, pharynx and esophagus, drugs are not required or not required at all. ^[11] A thick mixture of barium is swallowed in the supine position and fluoroscopic images of the swallowing process are taken. Then take several sips of the liquid mixture of barium and record the separation using fluoroscopy and standard radiographs. The procedure is repeated several times, tilting the examination table at different angles. In total, 350-450 ml of barium is swallowed. ^{[12] [13]} Normally, 90% of the swallowed fluid should pass into the stomach after 15 seconds. ^[14]

Barium flour and subsequent barium treatment

In control studies with barium flour or barium, a 6-hour fasting period is observed before the study. ^[10] Barium is given orally, sometimes mixed with diatrizoic acid, to shorten intestinal transit time. Metoclopramide is sometimes also added to the mixture to aid gastric emptying. Then X-rays are taken in the supine position at intervals of 20-30 minutes. Real-time fluoroscopy is used to assess intestinal motility. The radiologist may press or palpate the abdomen during the scans to separate the bowel loops. The total time required for the test depends on the speed of intestinal motility or transit time and can vary from 1 to 3 hours. ^{[15] [13]}

Enteroclysis

In this procedure, the contrast medium is continuously injected into the intestines, as well as intravenous administration of the contrast medium. Consequently, there will be greater distension of the small intestine compared to CT enterography, which may cause discomfort in the patient. ^[16]

When examining the small intestine, in addition to fasting for 8 hours before the examination, a laxative may also be needed to prepare and cleanse the intestines. ^[11] In case of enteroclysis into the intestine through the duodenum, 500 to 1000 ml of a liquid suspension of barium sulfate is continuously injected. then methylcellulose is instilled through the tube. Barium and methylcellulose fill intestinal loops, which can be viewed continuously with fluoroscopy, or viewed as standard radiographs taken at frequent intervals. The technique is a double contrast procedure that provides a detailed image of the entire small intestine.However, the procedure can take 6 hours or more and is rather inconvenient to complete. ^[17]

Interpretation of results

• Enteroclich proved to be very accurate in diagnosing diseases of the small intestine with a sensitivity of 93.1% and a specificity of 96.9%. This allows the detection of a lesion that cannot be seen with other imaging techniques. ^[7] There is no significant difference in the detection of clinically relevant results, sensitivity or specificity between enteroclysis and CT enterography. ^[1] When diagnosing pathologies of the mucous membrane of the small intestine, enteroclysm compares favorably with wireless capsule endoscopy and two-balloon endoscopy. ^[18]
• Interpretation of standard barium swallow tests for assessing dysphagia is operator and interpreter dependent. It has low sensitivity to subtle abnormalities, but is more sensitive than gastroscopy in detecting membranes and esophageal rings. ^[4] The best initial assessment of suspected oropharyngeal dysphagia is with barium. ^[19] Studies of barium swallowing remain the main study of dysphagia. ^[20] Barium studies may reveal pharyngeal tumors that are difficult to visualize endoscopically. ^[21]
• Subsequent barium imaging is the most commonly used imaging modality in evaluating patients with Crohn’s disease, although CT and magnetic resonance imaging are widely considered superior. ^[1] However, barium studies remain the best at detecting mucosal abnormalities. ^[18] The features of Crohn’s disease are well described by subsequent barium studies, looking like a typical “cobblestone pattern”, but no information has been received regarding extraluminal diseases. ^[22] Radiographic imaging in Crohn’s disease enables clinicians to objectively assess areas of the small intestine that are not accessible to standard endoscopic techniques. ^[23] Because of its length and complex loops, the small intestine is the most difficult part of the gastrointestinal tract to assess.Most endoscopic techniques are limited to proximal or distal segments, so barium follow-up remains the test of choice in most centers for abdominal pain, diarrhea and, in particular, mucosal abnormalities such as celiac disease and Crohn’s disease. ^[20]
• Barium swallowing studies are better than endoscopy for demonstrating the anatomical results of gastroesophageal reflux disease after antireflux surgery. ^[24]
• Barium fluoroscopy has several advantages over computed tomography and magnetic resonance imaging, such as higher spatial resolution and the ability to examine intestinal motility and distension in real time. ^[25]
• Many infections and parasitic infestations result in patterns on the lumenal surface that are best seen on barium studies. Certain parasites are considered filling defects identified by barium and barium tests, which play an important role in the diagnosis of intestinal infections and infestations compared to other methods. ^[26] Barium studies show tapeworms and roundworms as fine, linear filling defects in the intestine. ^[27] Because roundworms have a well-developed digestive tract, barium can delineate the intestines of parasites in retention images. In Strongyloidosis, barium studies show swelling of the intestinal wall, thickening of the intestinal folds with flattening, and atrophy of the lining mucosa. ^[27] Schistosomiasis is caused by infection with flatworms to have an appearance resembling ulcerative colitis in inflammatory polyps, ulcers, fibrosis, wall thickening, loss of haustation, and stenosis on x-rays with barium. ^[27] Anisakias Barium X-rays show swelling of the intestinal wall, thickening, ulceration, or stricture due to inflammation. Sometimes the worms are long filamentous linear filling defects up to 30 cm long. ^[27] B Tiflit Studies with barium show swelling, ulceration and inflammation of the intestinal wall, leading to thickening of the wall. ^[27] In pseudomembranous colitis, barium studies show pancolitis with a thumbprint and furry edges, and an eccentric, nodular, or plaque polypoid appearance. ^[27]
• Barium studies and computed tomography are the most common instruments used to diagnose the gastrointestinal tract. lymphoma. Barium contrast is more sensitive in showing subtle mucosal and submucosal abnormalities, but computed tomography is the method of choice for determining the extent of disease and staging and associated complications such as fistula and perforation. Submucosal nodules or masses form a target or target in barium studies. ^[28]

Side effects

Barium in the lungs from aspiration during barium ingestion

X-ray examinations include X-ray exposure. ^[22] Although barium ions are toxic, their use is generally considered safe because the small amounts of barium ions available in solution and absorbed by the gastrointestinal tract are considered negligible; however, isolated cases of barium encephalopathy have been reported following absorption of barium from the intestinal tract. ^[29] Constipation and abdominal pain may occur after ingestion of food with barium. ^[29] Barolite formation, which may need to be surgically removed, is a complication of the use of barium sulfate. ^[29] Barium sulfate may cause severe irritation of the peritoneum. Leakage of barium sulfate into the abdomen can occur in people with duodenal ulcers or other perforations and can lead to peritonitis, adhesion, and granulomas; this is associated with a high mortality rate. ^[11] Barium leakage into the mediastinum or abdominal cavity may result in endotoxic shock, which is often fatal; as a result, the use of barium as a contrast agent is contraindicated if there is a suspicion or possibility of a violation of the integrity of the intestinal wall. ^[29] Aspiration or inhalation of barium sulfate into the lungs during oral administration may result in serious respiratory complications that can be fatal. aspiration pneumonia or asphyxiation. ^[29] Hypersensitivity and allergic reactions are rare, but some of the additives in barium preparations can cause immune reactions. ^[29] Complete gastrointestinal obstruction is also a contraindication to barium testing. ^[15]

History

Barium sulphate contrast agent was obtained from previous use of bismuth preparations that were too toxic. The use of bismuth preparations was described as early as 1898. ^{a b c d e f} Sinha, R; Rajesh, A; Rawat, S; Rajiah, P; Ramachandran, I (May 2012). “Infections and invasions of the gastrointestinal tract. Part 2: parasitic and other infections. ” Clinical Radiology . 67 (5): 495-504. ^{a b c d e f} Baert, Henrik S. Thomsen; Judith A.V. Webb (ed.). With the participation of P. Aspelin … Foreword by A.L. (2009). Contrast Materials: Safety Issues and ESUR Recommendations; with 24 tables (2., ed. Ed.). Berlin: Springer. Schott, G.D. (16 Aug 2012). “Some observations on the history of the use of barium salts in medicine.” Case history . 18 (1): 9-21. Doi: 10.1017 / S0025727300019190. PMC 1081520. PMID 4618587.

Gastric barium meal angiography-Radiographic-Healthfrom.com

Gastric X-ray is mainly based on dual contrast angiography, and a comprehensive examination program for mucosal, filling and compression techniques is useful in identifying lesions and improving diagnosis.Normal stomach cramps: 1, upper lens: supine, stomach filled with filling phase, stomach body mucous phase, anterior pyloric pyloric region contains gas, stomach wall very clean, stomach antrum dilated. 2, lower lens: the supine position of the stomach, the antrum of the stomach is contracted, the bottom is still full, the stomach is the mucous membrane. The large curved gastric mucosa is serrated and normal. The duodenal bulb is triangular and the descending part is not completely filled.

Basic information

Specialist classification: digestive examination classification: X-ray

Applicable gender: whether men and women apply fasting: fasting

Tips: High-density preparations such as iodine, bismuth and iron are prohibited 3 days before angiography. Normal value

Normal stomach cramps:

1. The upper lens is in the supine position, the fundus is filled with the filling phase, the body of the stomach is the mucosal phase, the anterior pyloric part contains gas, the stomach wall is very clean, and the antrum is in the diastolic condition.

2. The lower antrum of the lower antrum is in a contracted state, the bottom is still full, and the stomach is slimy. The large curved gastric mucosa is serrated and normal. The duodenal bulb is triangular and the descending part is not completely filled.

Clinical significance

Abnormal results:

1. Gastric double contrast method can clearly show the fine structure of the surface of the gastric mucosa, such as the stomach area, which is valuable for the diagnosis of early gastric cancer and microscopic lesions.

2. Dual contrast angiography can show microscopic changes in the mucosal surface, which is important for the diagnosis of early gastric cancer. It is easy to detect lesions above 2 cm, and accurate X-ray examination based on double contrast angiography can be found within 1 cm. Small stomach cancer, even tiny stomach cancer within 5 mm.

Need to check crowd

1. Upper abdominal discomfort and upper abdominal mass.

2. Congenital gastrointestinal disorders.

3. Review after stomach surgery.

Precautions

Taboo before examination:

1. Ask your doctor to open the application form for examination and contrast medication (barium sulfate, etc.).

2. Eat easily digestible foods until the day of angiography. Fasting before angiography, without water for more than 6 hours, the stomach is empty.

For 3, 3 days before angiography, high-density drugs are prohibited, such as: iodine, strontium, iron, and so on.

Inspection requirements. Gastric X-ray is mainly based on double contrast angiography, and a comprehensive mucosal examination program, filling method and compression method are useful in identifying lesions and improving diagnosis. So please pay attention to the doctor.

Inspection process

When examining an enema of sputum or sputum, only the outline of the digestive tract is visible, and a tincture-filled gastrointestinal angiography often masks tiny lesions, so an oral foaming agent is often used or injected into the intestinal tract, so that the gastrointestinal tract has a high density.Tincture and low density air shadow form high contrast angiography, easy to obtain a positive result. According to the needs of clinical diagnosis and treatment, GI barium meal angiography can be divided into barium meal in the upper alimentary tract, barium meal in the complete alimentary tract, barium enema in the colon, and barium enema in the small intestine.

Not suitable for the crowd

Inappropriate people: Patients with acute respiratory infections, patients with severe cardiac, hepatic and renal dysfunction, and patients with a positive iodine test are generally not eligible for this test.

Adverse reactions and risks

1, may cause infection.

2, may cause perforation of the gastrointestinal tract.

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