What to expect and side effects

A barium swallow is a type of test used to look inside the esophagus, or food pipe. A doctor might recommend this test if they need to look at the outline of any part of a person’s digestive system.

Barium is a white liquid that is visible on X-rays. Barium passes through the digestive system and does not cause a person any harm.

As it passes through the body, barium coats the inside of the food pipe, stomach, or bowel, causing the outlines of the organs to appear on X-ray.

Share on PinterestA barium swallow can help a doctor identify problems in the food pipe, stomach, or bowel.

A barium swallow test may be used if someone has any of the following conditions:

• frequent, painful heartburn
• gastric reflux, where food or acid keeps coming back up the food pipe
• difficulty eating, drinking, or swallowing

This test can give a doctor information about how the person is swallowing.

It can also reveal if someone has any of the following in their food pipe, stomach, or the first part of the bowel:

• ulcers
• abnormal growths
• blockages
• narrowing

If someone has a tumor, this will show up on the X-ray as an irregular outline that extends from the wall of the affected organ.

People who are undergoing a barium swallow should not eat or drink for a few hours before the test. In some cases, the doctor may ask the person to stop taking medication before the test.

Some hospitals recommend not chewing gum, eating mints, or smoking cigarettes after midnight the night before a barium swallow test.

The test takes around 60 minutes and will take place in the X-ray department of the hospital. A person will need to change into a hospital gown.

People can bring a friend or relative for support. However, the companion will not be able to join them in the X-ray room.

In the X-ray room, the person drinks the barium liquid. It often has a chalky taste but can sometimes be flavored.

Share on PinterestA person will lie on a tilting table for part of the examination.

In some cases, a person will be given an injection to relax their stomach.

A person will be standing for some parts of the examination, and lying down on a tilting table for other parts. This allows the liquid to travel through the body, and for the radiologist and radiographer to take a selection of images.

People do not have to stay in hospital after the test and are free to go home as soon as it is complete. The results usually arrive within 1-2 weeks.

Risks and side effects

Patients may feel nauseous after a barium swallow test or become constipated. Drinking lots of fluids can help to relieve constipation. Symptoms of nausea should improve as the barium passes through the system.

It is normal for people to have white-colored stools the first few times they use the toilet after having a barium swallow test.

Some people might worry about being exposed to radiation as part of the X-ray process. However, the amount of radiation a person is exposed to is minimal.

Sometimes, the injection given to relax the stomach can cause temporary blurred vision.

Special considerations

People should not have a barium swallow test if they are pregnant.

If someone has glaucoma or heart problems and needs to have a barium swallow, the doctor may not give the stomach-relaxing injection.

If someone has diabetes then the doctor will schedule a morning appointment for the barium swallow.

If the person takes tablets to control their diabetes, the doctor will tell them not to take the medicine before the test. Instead, they should bring their tablets and some food to the exam to have after it is complete.

People who use insulin will be asked to miss their morning dose and maybe the previous evening’s dose. They should bring their insulin and some food to have after the test. However, those who take long-acting insulin should continue taking this.

Share on PinterestA barium enema allows doctors to examine the colon and rectum.

Another type of barium test is a barium enema. The barium enema test is similar to the barium swallow test and is used by doctors to examine the colon and rectum.

This test usually takes about 40 minutes. A person will be given a laxative the day before having a barium enema test. A laxative is a medicine that helps to clear out the bowel.

During the test, the person lies on their side on a table in the X-ray room. An enema containing barium and water is fed into their rectum through a small plastic tube. Air is also piped through the tube to inflate the bowel.

The table tilts, which spreads the barium throughout the colon. This allows the radiologist and radiographer to clearly see any lumps or swellings within the colon.

The person has to try and hold the liquid in the rectum while the test takes place. Afterwards, most of the liquid drains back into the tube and does not stay in the body.

After having a barium enema test, people may experience some cramping or diarrhea. As with the barium swallow, someone undergoing a barium enema may also have white stools the first few times they go to the toilet after the test.

There is a very small risk of the bowel lining tearing when having this test. This complication only tends to happen if the bowel is very inflamed.

Alternatives to a barium swallow test

An alternative to a barium swallow is a gastroscopy. In this procedure, a narrow, flexible, telescopic camera is used to look inside the food pipe, stomach and the first part of the small intestine.

A computed tomography (CT) scan may also be used in combination with a gastroscopy to provide X-ray images of the gut.

Barium tests – Better Health Channel

The barium swallow, barium meal and barium enema are tests that help with diagnosing problems of the digestive system.

Barium is a white, ‘radio-opaque’ powder that is visible with x-rays. It is used to demonstrate the structure and the function of the organs that make up the digestive tract, such as the oesophagus, the stomach, duodenum, small bowel and large bowel.

Barium tests allow a radiologist (a medical practitioner who specialises in making a diagnosis from radiology examinations) to evaluate a wide range of problems that may be the cause of your symptoms including: areas of reflux, narrowing or ulceration to the digestive tract.

Other tests such as endoscopy or computerised tomography (CT) scan are now more commonly used than the barium test to examine the digestive tract.

Barium swallows and enemas

Barium (barium sulphate) powder mixed with water can be swallowed (flavouring may be added) or introduced to the bowel as an enema through a tube inserted into the rectum. The mixture passes quickly into your digestive tract, and its progress is followed by taking x-rays over different periods of time, depending on which part of your digestive tract the doctor wants to observe.

The images produced are created using a special type of x-ray machine called a fluoroscope, which projects the images onto a video screen.

A barium swallow is used to help diagnose a problem with swallowing or reflux. The examination allows the radiologist to observe and evaluate your swallowing motion. It is also used to examine the structure of your oesophagus.

The barium meal is used to evaluate and diagnose problems with the stomach and duodenum, and the barium enema is used to evaluate and diagnose problems affecting the large bowel.

Problems that may be diagnosed with barium tests

By reviewing the images taken during the barium swallow, meal or enema tests, a radiologist can evaluate and diagnose a wide range of problems which may include:

• abnormal shape of the digestive tract
• areas where the digestive tract has become narrow
• ulceration
• damage to the digestive tract lining.

Before having a barium test

If you are going to have a barium test, before the procedure, be sure to discuss the following with your referring doctor or with the radiology staff:

• bowel habits – if you are constipated, you will be given a laxative the night before the barium meal. For the enema, you will be given a specific diet and laxatives to ensure the bowel is clear. You will probably need to take the laxatives for two days before the test
• eating – you are not allowed to eat or drink anything for eight hours before the test. The radiologist can have difficulty making an accurate evaluation of the images if there are particles of food in the digestive tract
• health conditions – at the time of booking you will need to tell the radiology staff if you have insulin dependent diabetes so that you can decide together the best time for you to fast and have the test
• pregnancy – pregnant women should not have these tests.

Barium test procedure

When doing a barium test you may experience cramping. This can be uncomfortable and can make it difficult for the radiologist to accurately evaluate the images.

To prevent cramping, you may be given an injection of a medication that will help relax the muscles of your digestive tract. This medication may be given directly into a vein or into your muscles. Before giving you the medication, the radiologist may ask you if you have glaucoma. This medication is not recommended for people with glaucoma. If you have this condition an alternative medication may be used.

During the examination, you will be asked by the radiographer to stand or lie in a number of different positions while images are being taken. The x-ray machine is linked to a television monitor and photographs or video footage will be taken to record the examination. Generally, the procedure takes around 20 minutes.

For some examinations, the radiologist may require images to be taken over a period of a few hours (three to six hours) to observe the barium as it passes along the small or large bowel.

Barium swallow and barium meal – procedure

During a barium swallow, you will be asked to drink the barium so the radiologist can observe your swallowing and evaluate the structure of your oesophagus. This may include tilting your head up and down as you swallow so that images can be taken of how your oesophagus works when your head is in different positions.

The barium meal is used to evaluate your stomach. The test may be combined as a barium swallow and barium meal. The radiologist will take images of both your oesophagus and your stomach.

During a barium meal you will be asked to drink a mixture that is fizzy, or two substances. These drinks contain ingredients that cause gas to be produced, which expands your stomach and the duodenum. When the gas is combined with the barium it creates a coating on the inside of your stomach and allows the radiologist to evaluate the stomach lining. Many people feel the urge to burp during this part of the examination.

Barium enema – procedure

During a barium enema, the barium sulphate is introduced into your bowel through a tube inserted into your rectum. The fluid is moved around your large bowel while the radiologist watches using x-ray fluoroscopy.

Some barium may be drained and then replaced with air by the radiologist. This is so the whole of the large bowel can be viewed, and any changes caused by your condition can be seen. Some people find this part of the examination a little difficult or embarrassing, as you may experience cramps or flatulence (farting).

After a barium test

After a test involving barium, you can expect to experience:

• constipation
• light-coloured faeces (poo)
• flatulence (depending on the examination)
• blurred vision (for an hour or so), if you have been given a muscle relaxant. Do not drive until your vision returns to normal.

Possible complications of barium tests

Barium examinations are safe tests, but complications can sometimes occur. These may include:

• If a section of the digestive tract has an undiagnosed break or split (perforation), the barium may leak into the abdominal cavity.
• If the bowel is obstructed, the barium can become impacted.
• The barium can lodge in the appendix and cause appendicitis.
• There may be side effects (such as blurred vision) from the medications used during the test.
• It is possible to accidentally breathe in the barium meal instead of swallowing it (this is very rare).

Self-care after a barium test

Be advised by your referring doctor or the radiology staff, but general suggestions include:

• Barium can cause constipation, so it is best to drink plenty of fluids for at least one full day following the test.
• Eat more fruit and other high-fibre foods than usual for the next day or two.
• See your referring doctor if you haven’t had a bowel movement within three days of the examination.

Long-term outlook after a barium test

You will need to make another appointment with your doctor to discuss the results of your barium examination. If no abnormality or cause for your symptoms is found, you may require further tests. Treatment depends on the diagnosis.

Other tests for examining the digestive tract

Other tests are now more commonly used than the barium test to examine the digestive tract. These include:

• flexible endoscopy – an endoscope is a slender tube with a lens at one end and a telescope at the other. This is inserted through an orifice (such as the mouth or anus) or a small incision, and the doctor looks down the telescoped end for a magnified view
• computed tomography (CT) scan – the CT scan uses x-rays and digital computer technology to create an image of internal body structures. Nowadays CT can be used to replace an endoscopy – this test is called a virtual colonoscopy.

Where to get help

• Your GP (doctor)
• Radiology clinic staff

How dangerous is the radiation dose received during the examination? How do I prepare for a barium stomach x-ray?

Contrast radiography, or barium x-ray of the stomach, is a method of examination that allows you to get a series of detailed images of the internal structure of the digestive organs.

Procedure specification

With the help of the examination, the specialist receives data on the size, shape and structure of the stomach. Since conventional x-rays do not allow a clear image of the soft tissues and the stomach cavity, a contrast agent, barium sulfide, is used to obtain detailed images. With an x-ray of the stomach with barium, the doctor can assess the dynamics of filling the organ, which shows the norm or pathology of its motor function.

When is the procedure indicated?

The examination is carried out in case of suspicion of diseases and pathologies that can pose a serious danger to the patient. In most cases, a barium x-ray of the stomach allows you to confirm or clarify the diagnosis and prescribe the correct treatment.

Suspicion of gastric and duodenal ulcer

Peptic ulcer of the stomach and duodenum (DUD) leads to the periodic appearance of ulcers. It can develop over the years and cause serious harm to health. On a barium x-ray of the stomach, a specialist finds an ulcer and evaluates its size, shape and other parameters, as well as establishes the stage of the disease and detects accompanying symptoms.

Detection of a malignant process in an organ

If a malignant process is suspected, an x-ray of the stomach with barium is recommended to be done without fail, since the consequences of the disease can be deadly for the patient. In the pictures, the cancer process looks like a defect in the mucous membrane. Often, after a barium x-ray of the stomach, an endoscopic examination is performed, and a sample of the neoplasm is taken for laboratory examination.

Diverticulosis and other gastric wall deformities

For the diagnosis of protrusion of the walls (diverticulosis), a barium x-ray of the stomach requires additional preparation. After the injection of the contrast agent, the patient alternately raises the upper and lower parts of the body so that the contrast fills the entire cavity of the organ.

On a barium x-ray of the stomach, small diverticulosis looks like an ulcer, but has a horizontal level and a neck.

Any inflammation of the stomach

Foci of inflammation in the stomach can appear as a result of various processes. Including with peptic ulcer or oncology. An x-ray of the stomach with barium allows you to find the focus of inflammation and, by indirect signs, establish its cause.

Swallowing dysfunctions

Dysphagia, or swallowing dysfunction, is often expressed by the fact that the patient complains of the inability to swallow food and its accumulation in the esophagus. In this case, the patient cannot always accurately indicate the place of the obstacle. Therefore, for the exact localization of the pathology, radiography of the stomach with barium is used.

Pain in the abdomen or umbilicus

Pain in the navel and abdominal area may indicate the development of malignant processes in the stomach and duodenum. Therefore, with such symptoms, the specialist often directs the patient to an x-ray of the stomach and duodenum with barium.

What can be found on x-rays?

If a barium x-ray of the stomach is performed correctly and with proper patient preparation, the examination can provide enough comprehensive information to make a diagnosis in most cases. At the same time, to detect a particular disease, a specialist evaluates a number of parameters.

Gastric lumen disorders

Violations of the lumen of the stomach may indicate the development of a malignant process or diverticulosis. If the lumen is narrowed on an X-ray of the stomach with barium, diffuse fibroplastic carcinoma is possible. In diverticulosis, the barium x-ray of the stomach looks larger than normal.

Disorder of stomach placement

Gastroptosis (prolapse of the stomach) is often diagnosed with a hernia of the abdominal wall or diaphragmatic hernia. The disease is clearly visible with the help of radiography of the stomach with barium.

Niche symptom

A niche is called a shadow of a contrasting mass that fills a defect in an ulcer or the development of a malignant process. Depending on the location of the defect, on the x-ray of the stomach with barium, a contour and relief niche is distinguished. In the first case, the silhouette of the defect is seen from the front, while in the second case, it is seen in profile.

The lack of filling is visible on the picture as a dark area

A dark area on a barium x-ray of the stomach indicates the presence of a place where the contrast could not reach. As a rule, this happens with atrophic gastritis or tumors.

How will the patient prepare for the procedure?

Since the patient needs time to prepare for a barium x-ray of the stomach, it is best to start a few days before the examination. The first step is to exclude from the diet foods that cause increased peristalsis and gas formation. 8 hours before the examination, you should completely refuse food.

To relax the stomach before the X-ray and prepare it for filling with barium, the doctor may recommend taking a special preparation half an hour before the examination. The contrast is administered orally a few minutes before the procedure.

When a double contrast examination is required, after the patient has prepared for the stomach x-ray and taken barium, he will need to drink a gas mixture.

Is barium harmful to the body?

The barium sulfate solution used in X-rays is not absorbed into the blood and is excreted naturally from the body. Therefore, to the question of whether barium, which is used in stomach x-rays, is harmful, the answer is obvious: no.

When is x-ray prohibited?

A barium x-ray of the stomach is a safe examination, but since it is done using ionizing radiation and a contrast agent, the method has a number of contraindications.

Hematopoietic disorders caused by pathological conditions of the bone marrow

Ionizing radiation can aggravate the disease. Therefore, in violation of hematopoiesis, an x-ray of the stomach with barium is not performed.

Cataract

When x-raying the stomach with barium, the radiation dose does not exceed the permissible limits. However, with cataracts, even a limited amount of ionizing radiation may be enough to have a negative effect on the state of the lens.

Malignant neoplasms of bronchi and lungs

The examination is contraindicated if the patient is being treated with radiation or chemotherapy.

Pregnancy

During pregnancy, even slight radiation can have a detrimental effect on the development of the fetus. Therefore, an x-ray from the stomach with barium is contraindicated for expectant mothers.

Childhood (before the onset of puberty)

In childhood, the body reacts poorly to exposure to even small doses of ionizing radiation. Therefore, doctors refer children to a stomach x-ray with barium only when absolutely necessary.

Diseases of the thyroid gland

X-ray exposure of an unhealthy thyroid gland can impair its function.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

X-rays of the upper GI tract and small intestine in children with cancer

X-rays of the upper GI tract (gastrointestinal tract) allow radiologists to examine the upper GI tract. It includes examination of the esophagus, stomach, and upper part of the small intestine (duodenum).

What is an x-ray of the upper GI tract and small intestine?

X-ray of the upper GI tract and small intestine includes examination of the esophagus, stomach and entire small intestine.

Watch this video

How is an x-ray of the upper GI tract (and small intestine) taken?

This procedure uses a technology called fluoroscopy to look inside the body and see the internal organs in motion. It’s like an “interactive” x-ray, which is displayed on a computer screen. The patient swallows a contrast fluid containing a special substance – barium. This milky white liquid enhances the definition of the esophagus, stomach and intestines in the image. Radiologists watch as barium moves through the gastrointestinal tract. Some patients are also given baking soda crystals (such as Alka-Seltzer®) to further improve the image. This procedure is called an upper GI x-ray with air or double contrast.

X-ray of the upper GI tract helps to find the cause of some symptoms:

• Abdominal pain
• Gastrointestinal bleeding
• Persistent vomiting
• Insufficient weight gain

The upper GI tract includes the esophagus, stomach, and upper part of the small intestine (duodenum).

How long does the procedure take?

Upper GI x-ray takes 20 minutes to an hour.

X-rays of the upper GI tract and small intestine may take 2-6 hours or more. Its duration depends on how long it takes the contrast fluid to pass through the small intestine.

Who performs upper GI x-rays?

The examination is performed by a radiologist and a radiologist.

Is X-ray of the upper GI tract safe?

Upper GI x-ray is a type of x-ray. A small amount of ionizing radiation is used to create images. The medical benefits far outweigh the risks associated with exposure to this small dose of radiation. Any concerns can be discussed with doctors.

How should patients prepare for an examination?

• Patients should be examined on an empty stomach: do not eat or drink for several hours before the procedure.
• Hospital staff will give the family the necessary instructions, depending on the patient’s age. They must be strictly followed, otherwise the examination will be postponed.

How can parents help the patient prepare?

Make sure your child:

• Understands the examination and knows what will happen. Child adjustment specialists can help explain this.
• Wear loose, comfortable clothing that is easy to put on and take off. The patient will probably need to change into a hospital gown.

What should I do before the examination?

• In some hospitals, parents may need to contact the insurance company to find out how much of the cost of the procedure will be reimbursed.
• Parents must provide the following information to the physician:
  • Names of all medications the patient is taking, including OTC medications.
  • Allergy, especially to contrast fluid (barium).
  • Information about the patient’s possible/existing pregnancy.
• Leave home early. It is important to arrive on time, and preferably a few minutes earlier, in order to have time to check in.
• Parent and patient will need to wait in the waiting room until it is time for the procedure. Bring along toys to keep your child occupied while waiting.
• The mother or father can usually stay with the patient during the procedure (if the mother is not pregnant). If necessary, parents should make arrangements with another adult to accompany the child.
• Brothers and sisters are generally not allowed in the x-ray room. Find someone to babysit other kids when you’re away.

What happens during an upper GI x-ray?

• A radiology staff member will talk to the family about why the patient needs an upper GI x-ray and explain the procedure.
• A staff member will help the patient lie down on the X-ray table.
• The patient will drink a barium mixture that sharpens the esophagus, stomach, and intestines on the x-ray screen. Barium has an unpleasant chalky taste. In some centers, flavoring is added to the solution.
• An employee will move the X-ray unit over the patient.
• The radiologist will take several pictures as the barium moves through the gastrointestinal tract.
• Staff will assist the patient in different positions so that images can be taken from different angles.

How does the patient feel?

The procedure is painless. The X-ray machine does not touch the patient.

Contrast fluid may taste unpleasant. You can ask to add flavoring to it.

The examination may take several hours depending on how quickly the barium passes through the system. Discuss with staff what the patient can do while waiting.

What does the patient feel after the examination?

Give the patient plenty of fluids as barium can cause constipation.

Barium can also cause white or gray stools for a day or two.

How do I know the results?

The radiologist will review the results and send a report to the doctor who ordered the test. The doctor will tell you about the results at the next appointment.