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Preparation for barium swallow test: Barium Swallow | Johns Hopkins Medicine


Barium Swallow | Johns Hopkins Medicine

What is a barium swallow test?

A barium swallow test (cine esophagram, swallowing study, esophagography, modified barium swallow study, video fluoroscopy swallow study) is a special type of imaging test that uses barium and X-rays to create images of your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.

Barium is used during a swallowing test to make certain areas of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

A barium swallow test may be used by itself or as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).

Fluoroscopy is often used during a barium swallow test. Fluoroscopy is a kind of X-ray “movie.”

Why is a swallow test done?

A barium swallow test may be done to look for and diagnose problems in
the pharynx and esophagus. You may need a barium swallow test if your
healthcare provider thinks that you have:

  • Cancer of the

    head and neck, pharynx, or


  • Hiatal hernia. This means that your stomach has moved up into or alongside
    the esophagus.

  • Structural problems, such as pouches (diverticula), narrowing
    (strictures), or growths (polyps)

  • Enlarged veins (esophageal varices)

  • Muscle disorders, such as difficulty swallowing (dysphagia) or spasms

  • Achalasia

    . This is a condition in which the lower esophageal sphincter
    muscle doesn’t relax and allow food to pass into the stomach.

  • Gastroesophageal reflux disease (GERD)

    and ulcers

Your healthcare provider may have other reasons to recommend a barium
swallow test.

What are the risks of a barium swallow test?

The risks of a barium swallow test may include problems from radiation
exposure, birth defects and intestinal issues. You should ask your
healthcare provider about the risks as they apply to you.

How can I manage my X-ray exposure?

You may want to ask your healthcare provider about the amount of radiation
used during the swallowing test. Consider writing down all X-rays you get,
including past scans and X-rays for other health reasons. Show this list to
your provider. The risks of radiation exposure may be tied to the number of
X-rays you have and the X-ray treatments you have over time.

How will a barium swallow test affect my stool?

You may have constipation or impacted stool after the swallowing test if
all of the barium does not pass out of your body.

Is it safe to have a barium swallow test while pregnant?

You should also not have a barium swallow test if you are pregnant.
Radiation exposure during pregnancy may lead to birth defects. Tell your
provider if you are pregnant or think you may be pregnant.

When should I avoid a barium swallow test?

You should avoid a barium swallow test if you have any of the following:

  • A tear or hole in your esophagus or intestines (perforation)

  • Blockage in your intestines or severe constipation

  • Severe problems with swallowing. This makes it more likely that
    barium would accidentally go into your lungs (aspiration).

You may have other risks depending on your specific health condition. Tell
your provider if you are allergic to or sensitive to medicines, contrast
dyes, local anesthesia, iodine, or latex. Be sure to talk with your
provider about any concerns you have before the procedure.

How do I prepare for a barium swallow test?

You can prepare for a barium swallow test by considering the following:

  • Your healthcare provider will explain the barium swallow test to
    you. Ask him or her any questions you have about the swallowing

  • You may be asked to sign a consent form that gives permission to do
    the swallowing test. Read the form carefully and ask questions if
    anything is not clear.

  • You will need to stop eating and drinking for about 8 hours before
    the swallowing test. Generally, this means after midnight.

  • Tell your provider if you are pregnant or think you may be pregnant
    before scheduling a barium swallow test.

  • Tell your provider if you are sensitive to or are allergic to any
    medicines, latex, tape, or anesthetic medicines (local and general)
    before scheduling a swallowing test.

  • Tell your provider about all medicines you are taking. This
    includes prescriptions, over-the-counter medicines, and herbal
    supplements. You may need to stop taking these before the
    swallowing test.

  • Tell your healthcare provider if you have had a recent barium
    swallow or upper GI test. This may make it harder to get good
    X-rays of the lower GI area during a barium swallow test.

  • Follow any other instructions your provider gives you to get ready
    for the swallowing test.

What does a barium swallow test involve?

Generally, a barium swallow test involves the following process:

  • You’ll be asked to remove any clothing, jewelry, or other objects
    that may get in the way of the swallowing test.

  • You may be asked to remove clothing. If so, you will be given a
    gown to wear.

  • You will lie on an X-ray table that can move you from a horizontal
    to an upright position. You may also be asked to change positions
    during the swallowing test. For example, you may need to lie on
    your side, back, or stomach.

  • The radiologist may take X-rays of your chest and belly (abdomen)

  • The radiologist will ask you to take a swallow of a thick, chalky
    barium drink. The barium is usually flavored, but it may not taste
    very good.

  • As you swallow the barium, the radiologist will take single
    pictures, a series of X-rays, or fluoroscopy to watch the barium
    moving through your mouth and throat.

  • You may be asked to hold your breath at certain times during the

  • You will be given a thinner barium drink to swallow. The
    radiologist will use X-rays or fluoroscopy to watch the barium go
    down your esophagus. You may also be asked to swallow a barium
    tablet. This is a small pill that can help to show certain problems
    in the esophagus.

  • Once the radiologist has taken all of the X-rays, you’ll be helped
    from the table.

A barium swallow test may be performed as an outpatient procedure or as
part of your stay in a hospital. The way the test is done may vary
depending on your condition and your healthcare provider’s practices.

What happens after a barium swallow test?

You may go back to your normal diet and activities after a barium swallow
test, unless your healthcare provider tells you otherwise.

How do I manage constipation after a swallowing test?

Barium may cause constipation or impacted stool after the swallowing test
if it isn’t completely cleared from your body. You can manage constipation
by drinking plenty of fluids and eating foods high in fiber to help the
rest of the barium leave your body. You may also be given a laxative to
help with this.

Your bowel movements may be white or lighter in color until all the barium
has left your body.

What are some serious side effects after a barium swallow test?

Call your healthcare provider right away if any of these happen after your
barium swallow test:

  • Trouble with bowel movements or you are unable to have a bowel
    movement or pass gas

  • Pain or swelling of the abdomen

  • Stools that are smaller in size than normal

  • Fever

Your healthcare provider may give you other instructions, depending on your

What to Expect from Your Barium Swallow Test


Your doctor may give you some dietary guidelines before your barium swallow test, and it’s important that you follow them closely if this is the case. In most cases, you aren’t supposed to eat or drink anything for six hours prior to the test, though you can take small sips of water up until two hours beforehand. If the test is combined with others, or if you have any medical conditions, your doctor may give you slightly different directions. Notify your doctor in advance if you have or have had any of these conditions:

  • A perforation of the esophagus or bowel
  • Bowel obstruction
  • Trouble swallowing
  • Severe constipation

During the Test

The steps for a standard barium swallow test will go as follows:

  • •You’ll go to a local radiology facility for your test, which will be performed by a radiology technician
  • •You’ll be asked to remove your clothing and any jewelry, and will change into a medical gown
  • •You’ll be positioned on an X-ray table, and potentially asked to move your body around as standard X-rays are taken of your heart, lungs and abdomen
  • •After this first round of X-rays, you’ll be given a barium drink to swallow
  • •Either X-rays or fluoroscopy will be done to watch how the barium moves through your pharynx and you may be asked to hold your breath at times to avoid disrupting the images
  • •From here, you’ll be given a thinner barium drink to swallow, and another set of X-rays or fluoroscopy will be done to watch how it moves down the esophagus

When all X-rays are complete, you’ll be finished. The test will take about 30 minutes, and there will be no restrictions to your diet or daily activities after the test unless your doctor specifies otherwise. You’ll hear from your doctor’s office within a few days to go over your test and schedule any necessary follow-up appointments.

Possible Side Effects

A barium swallow test does have some potential side effects, including constipation or fecal impaction. Drink lots of fluids and eat high-fiber foods to move the barium through your digestive tract, as these complications most often arise due to barium that remains in your body.

You may notice bowel movements that are lighter in color – once all the barium is removed from your body, this should stop. If you have trouble with bowel movements, pain or bloating in the abdomen, or stools that are smaller in diameter than usual, contact your doctor right away.

In addition, barium swallows do involve exposure to radiation from the X-ray. The risk of complications here can rise as your exposure over time does, and if you’re worried about this, you should review with your doctor all your past radiation procedures. Pregnant women should avoid barium swallow procedures, as these can cause birth defects.

Your doctor can offer additional information on a barium swallow test and can recommend it for you if it’s necessary.

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.

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.

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

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 | Oral, Laryngeal and Thyroid Cancer

Who is a candidate for a barium swallow

A barium swallow may be able to help diagnose conditions such as:

  • Hiatal hernia — where your stomach has moved up into or beside the esophagus
  • Inflammation or blockages in the upper gastrointestinal tract
  • Benign or malignant tumors (non-cancerous and cancerous) in the head, neck, pharynx and esophagus
  • Gastric ulcers
  • Gastroesophageal reflux disease (GERD)
  • Structural conditions — conditions such as strictures (narrowing), polyps (growths), diverticula (pouches)
  • Esophageal varices — enlarged veins
  • Achalasia —medical condition where the lower esophageal sphincter won’t relax to allow food into the stomach

You may not be able to have a barium swallow if you have any of the following conditions:

  • Tear or hole in the esophagus or intestines
  • Severe constipation
  • Problems swallowing that could accidentally allow barium to go into the lungs
  • You are pregnant

What are the side effects associated with a barium swallow

Some people experience constipation or fecal impaction if the barium is not completely expelled from the body after the procedure. If you experience constipation or fecal impaction, drink plenty of fluids and eat high-fiber foods to move the barium through the digestive tract. If that doesn’t work, your doctor can prescribe a laxative.

There are also side effects associated with the radiation that is used in the test. The risks associated with radiation exposure increase as you have more x-ray exams.

If you are pregnant or suspect you are pregnant, tell your doctor. Exposure to radiation during pregnancy can cause birth defects in unborn fetuses.

What to expect during a barium swallow

A barium swallow is performed in radiology by a radiology tech. The entire procedure takes approximately 30 minutes, and you should have results within a few days.

In preparation for the procedure, your technician will position you on the x-ray table, give you a barium drink and take a series of x-rays as the barium travels through the pharynx. Once the first set of x-rays has been taken, your technician will give you another, thinner barium drink and will take x-rays as the barium moves through the esophagus.

Barium is a chalky white substance that is used in the GI tract to help it show up on x-ray. Using barium, your doctor will be able to evaluate the size and shape of the pharynx and esophagus.

A barium swallow can be done as a standalone procedure or as a part of an upper GI series of tests that evaluate the entire upper GI tract. During this procedure, a fluoroscopy (a continuous x-ray beam) is used during a barium swallow to evaluate movement through your GI tract. In many cases, a barium swallow accompanies an esophagogastroduodenoscopy (EGD) or as a part of an upper GI and small bowel testing.

Recovery from a barium swallow

You will go home after a barium swallow and can return to your normal activities right away. You may experience constipation or notice that your bowel movements are lighter. Once the barium has passed from the body, your bowel function should return to normal.

If you experience any of the following side effects, call your doctor right away:

  • Inability to have a bowel movement
  • Pain in the abdomen
  • Smaller than usual stools

Barium Swallow/Upper GI | Baptist Health Paducah, KY

What is a Barium Swallow Test of the Upper Gastrointestinal (G.

I.) Exam?

An upper G.I. (UGI) examination is a diagnostic procedure that uses a contrast agent, called barium, to produce images of your upper gastrointestinal tract, including the esophagus, stomach and small intestine (small bowel). Using a type of x-ray, called Fluoroscopy, the UGI exam can detect problems with your upper digestive system and this procedure helps your doctor identify problems, with minimal risk and discomfort to you.

Can I Eat Before a Barium Swallow Test?

  • Do not eat or drink anything, including chewing gum, for eight to 12 hours before the exam – so your stomach and upper digestive tract are completely empty. You may brush your teeth but avoid swallowing any water. 

How Do I Prepare for My Exam?

To prepare for the UGI exam you should:

  • Remove any piercings from the abdomen and chest – so they do not interfere with the images produced during the exam.
  • Inform the technologist if you may be pregnant. If there is a possibility of pregnancy, a pregnancy test will be ordered before the exam.

If you have questions about the preparation or procedure, please call your physician’s office. Report to the registration area 30 minutes prior to your scheduled exam time to complete the registration process.

How Does a Barium Swallow Work?

For this exam, you will change from your clothing into a hospital gown so the area to be examined can be easily accessed. A technologist will gently position you on a special tilting table with a fluoroscope  (an X-ray machine combined with a television monitor). A radiologist or a radiology physician’s assistant will perform the UGI exam. These individuals specialize in the study of imaging tests, such as X-ray images, ultrasound, CT, etc., to assure the most accurate results from your examination.

You will be asked to drink a liquid barium mixture while the radiologist or physician’s assistant watches the barium flow through your digestive tract. In addition, “spot films” will be taken of the areas your doctor wants to study. You will be asked to turn and hold several positions so the radiologist can get images from many different angles.

How Long Will the Exam Take?

Time will vary significantly, depending on the nature of the study and other factors. Average time for UGI exams is 30 to 40 minutes. If you are also scheduled for small bowel series, the time will be considerably longer.
For small bowel series, the barium you drink is followed through 22 feet of your small intestine by taking abdominal images every 30 minutes until the barium has reached the colon. This usually takes a minimum of 60 minutes but everyone’s digestive system is different, so your study may take more or less time.

What Happens After My Exam?

After the exam, you are free to return to your normal activities and usual diet unless told otherwise by your physician.  Barium may cause constipation and It is normal for the barium to give a whitish color to your stool for the next day or two. You will need to increase your water intake and possibly take a mild laxative in order to clear the barium from your system within a day or two of your exam. If you have trouble with constipation normally, you should consult your physician for a specific treatment plan.

After your study is completed, the radiologist will interpret your images and send a written report to your physician. Your physician will review the results of the exam with you at your next scheduled appointment.

which shows and how to prepare

To identify pathological processes occurring in the human stomach, doctors use various diagnostic methods. Fluoroscopy is also often prescribed. But, the stomach and the surrounding parts are not so easy to see in the picture. The X-ray image shows the bones of the spine, sternum and hip region. As for the digestive system, barium is used for research. This is a tool that allows you to see the pathological processes occurring in the soft tissues of the body.

X-ray of the stomach with barium

Contents of the article:

In what cases is it appointed?

X-ray of the esophagus and stomach with barium reveals the presence of a large list of diseases and pathologies of the gastrointestinal system. The examination is prescribed when the formation of symptoms indicating the development of diseases.

These symptoms include:

  • Presence of nausea and gag reflex at any time of the day.
  • Rapid weight loss.
  • Difficulty swallowing.
  • Pain in the stomach.

X-ray of the stomach is used for the development of ulcers, cancer, hernia, the presence of foreign bodies in the gastrointestinal tract. Assuming the development of inflammatory processes.

Stomach structure

About contraindications

Barium X-rays of the stomach can be done in any hospital equipped with the necessary equipment.However, there are situations in which this procedure cannot be carried out.

  • During the period of gestation, a woman is not prescribed fluoroscopy with contrast.
  • It is not possible to carry out the procedure for patients in serious condition.
  • Do not use contrast in patients with acute bleeding and suspected perforation of ulcers in the gastrointestinal tract.

Preparing for the procedure

Preparation of the patient for a gastric barium x-ray is important to obtain the exact examination results shown in the photo.

This step includes the following steps:

  • 8-10 hours before the start of the procedure, the patient should stop eating and drinking. For children, these restrictions are more loyal. Children under the age of one year are limited to food and drinks 4 hours before the procedure, older children – 6 hours.
  • For patients of all age categories, 3 days before fluoroscopy, restrictions on the intake of foods that increase gas production are introduced in the diet.
  • This means that during this period you cannot eat or drink: sugary drinks, milk products, legumes, apples.

Taking into account the patient’s condition, the doctor may prescribe a cleansing enema and lavage of the digestive tract and stomach. To check the esophagus, the patient is encouraged to drink a small amount of barium. The substance spreads along the esophagus and reveals foci of inflammation. Then, the patient drinks the rest of the contrast medium and the examination continues.

Barium intake

Carrying out diagnostics

After the patient has taken a barium solution, he is offered to take a suitable position on the couch.To identify pathologies in the pyloric region and duodenum, the patient is turned to the apparatus at an angle of 45-70 0 . To obtain clear pictures, the left arm is bent at the elbow, the right hand is lowered down, and the head is raised.

Carrying out diagnostics

For a detailed examination of the stomach, the patient is placed on his stomach, offered to bend his arms at the elbows and raise them to the head. If there is a suspicion of a pathology in the back of the stomach, the patient is offered to lie on his right side, raise his arms and bend a little at the elbows.To identify pathologies in the duodenum and the pyloric region of the stomach, the patient is placed on the left side of the body and the body is turned by 60 0 . In this case, the hands should be raised to the head.

It is possible to reveal a hernia of the esophagus in a patient if the subject takes a supine position on the table, as we see in the photo. And the doctor will fix it with the help of special belts and lift the leg of the couch up. In this case, the organs in the abdominal cavity will move upward.With an enlarged opening of the esophagus, the stomach changes its location.


So, what does an X-ray of the stomach with barium show? This diagnosis allows you to identify the following pathological processes:

  • Gastritis.
  • Gastric atony.
  • Increased tone.
  • Peptic ulcer.
  • Presence of polyps, oncological neoplasms.
  • Protrusion of one of the walls of the stomach.
  • All kinds of abnormal processes in the development of the organ.

It is important to make an X-ray of the stomach with barium to identify the initial as well as advanced stages of gastrointestinal diseases. Thanks to this type of diagnosis, the doctor identifies not only abnormal changes, but also their shape, location, and the consistency of neoplasms.


A specialist gastroenterologist will tell you about the details of the procedure in the video.

In conclusion

To detect the slightest pathological processes occurring in the gastric organ and esophagus, fluoroscopy is prescribed.However, given that the stomach and other soft tissues are not displayed in the image with the usual technique, X-ray of the stomach is performed with a contrast agent – barium. It is an inactive substance that is not absorbed by the intestines and is excreted in the feces. Barium allows you to get an accurate picture of the state of the patient’s internal organs on fluoroscopy.

Medical Center “Consultant” – Fluoroscopy of the stomach

X-ray examination of the esophagus, stomach and duodenum is a contrast study aimed at clarifying the presence or absence of pathology of the upper digestive tract, and in the presence of pathology – to clarify the nature of the identified changes.

X-ray examination of the esophagus, stomach and duodenum is a completely safe, non-invasive procedure. Allergic reactions to contrast media are extremely rare due to the fact that barium sulfate is not absorbed from the digestive tract into the blood. The radiation dose received in the process of research on a modern digital apparatus is extremely small and does not lead to the development of negative consequences.

The study is carried out both in the vertical and in the horizontal position of the patient (on the stomach, on the back, on the left and right side).In some cases, the study is carried out in the Trendelenburg position – on the back with the head end of the table lowered (up to -30 degrees).
During the examination, the patient, at the command of the radiologist, takes a contrast agent – an aqueous suspension of barium sulfate. The contrast agent taken can be from a thick consistency to the consistency of liquid sour cream. The volume of the received contrast is from 150 to 300 ml. Swallowing a contrast suspension that tastes like chalk is generally straightforward.

The indications for fluoroscopy of the esophagus, stomach and duodenum are the following clinical symptoms:

  1. Suspected gastroesophageal reflux.
  2. Abdominal pain.
  3. Discomfort in the epigastric region.
  4. Digestive upset.
  5. Nausea.
  6. Vomiting.
  7. Symptoms of bleeding from the upper digestive tract.
  8. Anemia.
  9. Weight loss.

X-ray examination of the esophagus, stomach and duodenum is informative for the following diseases and pathological conditions:

  1. Suspected or known gastritis or duodenitis.
  2. Peptic ulcer of the stomach and duodenum.
  3. Hernia of the esophageal opening of the diaphragm.
  4. Varicose veins of the esophagus.
  5. Suspected perforation (plain abdominal x-ray is usually sufficient, contrast study is performed with a water-soluble contrast agent).
  6. Tumors of the esophagus, stomach, duodenum.
  7. Symptoms of obstruction of the upper digestive tract.
  8. Examination before stomach surgery.
  9. Examination after operations on the upper digestive tract.

ATTENTION! Preparation for research required!

To prepare for the study, it is necessary to abstain from food and liquids from 12 o’clock in the night prior to the study.On the morning of the study day, you should not brush your teeth, smoke, or chew chewing gum. On the morning of the study day, it is allowed to take the medication prescribed by the doctor (if any). The study is scheduled for the morning hours.

REMEMBER! The quality of training affects the amount of information received and, as a result, the diagnostic value of the study.

Make an X-ray of the stomach in Moscow

X-ray of the stomach is a diagnostic method for detecting functional disorders and diseases, which makes it possible to assess the size and shape of the organ, the integrity of the walls.This study is informative and easy to complete. The price, in comparison with other diagnostic methods, is low. It can be used provided there is no risk of developing oncological processes in the upper gastrointestinal tract. If available, it is better to use other imaging techniques for the gastric mucosa.

According to the results of diagnostics, it is possible to identify:

  • Ulcer;
  • Inflammatory processes;
  • Stomach cancer.

Complex X-ray examination: X-ray and fluoroscopy of the esophagus, stomach, duodenum 1940

Conditions of the procedure

The Law on Radiation Safety provides for the preliminary conduct of a number of studies: ultrasound, FGDS, laboratory tests.If these techniques do not clarify the situation, an X-ray examination of the stomach is performed.

When to do an X-ray of the stomach:

  • Suspected ulcer;
  • Inflammation;
  • Suspected cancer;
  • Deformation of the walls of the stomach;
  • Drastic weight loss;
  • Feces with blood;
  • Anemia;
  • Heartburn
  • Pain in the navel.

The procedure is suitable for those who have difficulty swallowing endoscopic devices and have a gag reflex.


Do not take x-rays of the stomach when:

  • Pregnancy;
  • Gastric bleeding;
  • Serious conditions.

Obstacles to using contrast are:

  • Wall perforation;
  • Intestinal obstruction;
  • Sharp abdomen.

The reason for the limitation is irritation of the peritoneum when the contrast enters.

Fluoroscopy of the stomach with barium

Plain X-ray of the gastrointestinal tract does not show changes, since X-rays easily pass through hollow structures, and they are not displayed on the images.

X-ray of the stomach with contrast aims to identify the area where the movement of the contrast medium is blocked. Places of contrast accumulation indicate a cancerous tumor or pathological narrowing of the intestine.

With the simultaneous introduction of air and barium (double contrast study), it is possible to track the changes occurring in pathologies – cancer, gastritis and ulcers.

Before the analysis, the doctor asks the patient a number of questions in order to determine the methodology and act purposefully.

What X-ray of the stomach and esophagus shows

The procedure will make it possible to track changes in the walls of the stomach and additional shadows in adjacent tissues.

  • Clearance change. Narrowing occurs with cancer of the stomach or other organ that compresses the stomach from the outside. Expansion is a sign of diverticula – acquired or congenital.
  • Stomach displacement. May occur with trauma or hernia.
  • Integrity violation. Changes are characteristic of peptic ulcer disease. The location of the defect on the radiograph is visualized as a darkening.
  • Filling defects. The place where the contrast has not penetrated can be a tumor, polyp, or neoplasm.
  • Thinning of folds is possible with atrophic gastritis.

Esophageal pathologies:

  • Narrowing or protrusion of diverticulums;
  • Vein dilatation;
  • Foreign bodies.

Diseases of the stomach:

  • Abnormal suction;
  • Duodenal ulcer.
  • Cancer.

Advantages of CDB RAS

  • Radiography is absolutely safe in terms of radiation exposure, thanks to modern equipment
  • High level of professionalism and responsibility of radiologists
  • No preliminary preparation and quick results

Preparation for procedure

The preparation rules take into account the patient’s condition.If the functions of the digestive system are not impaired, special training is not carried out. The only condition is that you should not eat for 6-8 hours before the procedure.

If there are disorders of the digestive function, a diet is needed:

  • Foods are excluded from the diet, the use of which causes the formation of gas in the intestines;
  • you can eat lean meat, fresh eggs, fish, cereals.
  • For constipation, the patient is prescribed an enema or gastric lavage.

How the procedure is performed

The examination includes examination of the stomach, esophagus and duodenum. The procedure conventionally consists of two parts:

  • Fluoroscopy;
  • X-ray of the stomach.

Both parts are performed by a radiologist, who then compiles the description.

Algorithm of the procedure:

  • Plain X-ray is taken to assess pathology.
  • The patient is taking barium. This is necessary, since the density of the organs under study does not differ from those adjacent to them. Acceptance of contrast leads to its gradual passage, which is monitored by a radiologist. A series of shots are taken at different positions.
  • When barium sulfate fills the organ completely, the doctor can analyze the correct functioning of the gastrointestinal tract.
  • The contrast agent is completely removed 1.5 hours after administration.The doctor uses this time to prepare a report.

Interpretation of results

The description of the information received is carried out by the doctor who observed the process. To obtain a complete picture, one X-ray is not enough.

The result of the examination is an image given to the patient, together with a detailed description.

Sample stomach image

Where to make an X-ray of the esophagus and stomach with barium

You can make an X-ray of the stomach and intestines at the clinic of the Russian Academy of Sciences (Moscow), for a fee.Diagnostics is carried out using high-quality modern equipment. Qualified and experienced medical professionals will conduct digital research and issue an opinion. Information about how much the research costs can be obtained by calling the specified phone number.

90,000 contraindications to the procedure, how to prepare, patient preparation, how to prepare, radiography

Gastric fluoroscopy is a common instrumental examination of the gastrointestinal tract, which acts as an alternative or addition to other methods of examination (FGDS, ultrasound).X-rays are often accompanied by the introduction of contrast, which increases the objectivity and information content of the information obtained. To obtain the most effective result from the procedure, it is necessary to comply with all the requirements for the preparation of the patient. Violation of some rules may lead to receiving erroneous data or to the need to repeat the procedure. Since unnecessary doses of X-ray radiation are undesirable, it is important to carry out the procedure correctly the first time. In this article, we will tell you how the preparation for the X-ray of the stomach proceeds

Preparation for the X-ray of the stomach

Indications for the appointment of the procedure

X-rays of the stomach are prescribed for patients with different purposes, which include:

  1. Statement, confirmation or refutation of the diagnosis.
  2. Establishing the causes of some symptoms.
  3. Evaluation of the results of surgery.

Important! It should be noted that there are fundamental differences between procedures for radiography and for fluoroscopy of the stomach. The first method involves a one-step image of an organ, and fluoroscopy allows the doctor to study the dynamics of some processes, observing them in real time. In the second case, several consecutive images are taken at once.

Symptoms that can cause the appointment of an X-ray of the stomach are:

  • painful sensations in the abdomen of unknown origin;
  • Detection of obvious or latent blood in feces;
  • Difficulty swallowing, impaired movement of food through the esophagus;
  • loss of appetite, weight loss, sudden anemia;
  • detection of seals of an unclear nature on palpation of an organ;

In addition, the methods of radiography and fluoroscopy are used to make, confirm or refute diagnoses of all kinds of diseases, defects and unhealthy conditions of the gastrointestinal tract.For example, radiography is most effective when there is a suspicion of foreign bodies in an organ.

After the operations on the gastrointestinal tract, a fluoroscopy procedure is often prescribed in order to evaluate the results of the manipulations, to make sure that internal processes are normalized.

Contraindications to the procedure

X-ray of the stomach is a fairly safe research method, however, there are contraindications to its use. Such contraindications include:

  1. Severe condition of the patient. When a patient is in a serious condition, the introduction of contrast with fluoroscopy can aggravate the patient’s condition or cause a crisis.
  2. Internal bleeding of any nature. Gastric, intestinal, esophageal bleeding are a direct contraindication to the procedure.
  3. Allergy to barium sulfate or other drugs used during the procedure.
  4. Pregnancy at any time. X-ray exposure is considered undesirable for pregnant women.The doctor will most likely decide on the appointment of an alternative research method.

In exceptional cases, when it is impossible to conduct other examinations, in agreement with the obstetrician-gynecologist, it is allowed to carry out an X-ray to pregnant women in the second and third trimester

General rules for preparing for fluoroscopy of the stomach for patients

doctor or patient special training techniques. There are, however, rules that must be strictly followed in order to obtain objective data and a successful procedure:

  1. The patient takes the last meal at least 12 hours before the procedure.
  2. On the day of the X-ray, you should stop taking medications, inhalation, smoking, using chewing gum.
  3. 2-3 ​​days before the study, you should adhere to a sparing diet that excludes any foods that contribute to gas formation.
  4. On the eve of the procedure, it is recommended to do a cleansing enema.
  5. If there is an obstruction of the pyloric gastrointestinal tract, then immediately before the study, the patient is prescribed a lavage using a probe.
  6. The patient should choose loose clothing that does not contain metal parts.
  7. Immediately before the procedure, you must get rid of any jewelry, dentures, excess clothing.

Compliance with the above rules will allow you to maximize the effect of the X-ray procedure of the stomach

Sparing diet before X-ray examination

A sparing diet before X-ray examination of the stomach is shown to everyone, without exception.The recommended duration of the diet is 2-3 days before the study, while the last meal and drink should be no later than 12 hours before the start of the procedure.

When following a diet, the following should be excluded from the diet:

  • fatty, fried, smoked, pickled and salty foods;
  • spicy food and any spices, seasonings;
  • dairy and fermented milk products;
  • Any products that cause the formation of gases;
  • potatoes;
  • flour and pastry products;
  • sweets.

Allowed use:

  • dairy-free cereals; 90,020 90,019 boiled eggs, lean meat, poultry and fish;
  • cooked or steamed non-starchy vegetables;
  • natural vegetable and fruit juices diluted with water to reduce acidity;
  • lean soups.

Correct adherence to a diet involves not only eating certain foods and avoiding others, but also careful control over the amount of food and diet.It is recommended to eat 4-5 times a day in small portions. Overeating and hunger should be avoided.

A sparing diet must necessarily be accompanied by a sufficient intake of clean drinking water (at least 1.5 liters per day), the volume of which does not include the use of liquid soups, tea and other drinks

During the diet, chewing gum, smoking, and sucking lozenges should be avoided, so how all this contributes to increased secretion of gastric juice and increased acidity of the gastric environment.

If the patient feels the need, then the intake of special medications can be added to the diet to help cleanse the body and get rid of gases. These drugs include:

  1. Espumisan (prevents gas formation, allows you to effectively fight it).


  2. Activated carbon (taken according to the instructions, depending on the total weight).

    Activated carbon

  3. Enterosgel (a modern analogue of activated carbon, has high absorption properties).


The presence of symptoms of GERD, reflux, heartburn of unknown origin in a patient allows taking antacids while adhering to a sparing diet.

Important! Remember that 12 hours before the procedure, you must stop taking any medications and even refuse water. At the time of the procedure, the stomach should be completely empty.

Preparing a patient for a contrast x-ray using barium

An x-ray using contrast allows you to more accurately assess the size, shape, functional state of the digestive tract, and fluoroscopy also allows you to trace the dynamics of the movement of substances along the esophagus, transitions.

Barium mixture solution is a suspension that the patient drinks in small sips as directed by the doctor performing the procedure.

Table 1. Step-by-step preparation for contrast x-ray with barium

Step Description
1 The doctor prepares a solution of barium sulfate sulfate, which is a form of suspension.
2 15 minutes before the start of the procedure, the patient is given 2-3 tablets of Aeron under the tongue, which helps to relax the stomach and intestines.
3 The patient takes the first couple of sips of contrast medium and assumes a supine position. At this stage, the doctor is able to assess the function of swallowing, the speed and characteristics of the movement of the contrast along the esophagus, the state of internal transitions.
4 The barium suspension is evenly distributed, and the doctor makes a series of shots that allow him to subsequently assess the reliefs of the organ under study.

In total, the patient will have to drink up to 150 ml of liquid contrast, which will allow the doctor to objectively assess the size, shape, contours and tone of the stomach walls.

The results of a successful fluoroscopy using a solution of barium sulfate sulphate allow to assess the peristalsis and the general condition of the intestine, the pyloric canal

Video – Scopy of the stomach with barium

Preparing the patient for X-rays using double contrast

9000 information that can be obtained by double contrast diagnostics, he prescribes additional stretching of the walls of the stomach with gas.This technique is carried out in conjunction with the use of a barium sulfate solution. At the same time, a special solution is prepared, it is several times denser than that used for fluoroscopy.

Table 1. Step-by-step preparation for x-rays with double contrast

Step Description
1 The doctor prepares a solution of barium sulfate sulfate, which is more saturated and dense than in a conventional contrast study.The dense contrast solution provides greater enveloping and adheres better to the walls of the stomach, in addition, it is more homogeneous in structure and does not interact with gastric juice.
2 Double contrasting in X-ray examination of the stomach involves preliminary thorough cleaning of organs from toxins and gases. To do this, use the drug “Fortrans” in a dosage of 1 sachet per 60-70 kg of the patient’s weight. If you are overweight, it is recommended to use 2-3 servings.
3 When using double contrast, together with the reception of the relaxing Aeron, a provocative allergic test is carried out. This is an obligatory stage of preparation, since a denser barium solution often causes allergic reactions in the body.
4 After consuming the full volume of contrast medium (about 60 ml of solution), the doctor takes a series of X-rays.
5 The blowing powder is drunk last.In this case, the patient should be in a horizontal position and strictly follow all the instructions of the doctor performing the procedure.

The results of X-ray and fluoroscopy using double contrast allow you to get the maximum amount of information about the state and processes of the patient’s gastrointestinal tract.

Despite the fact that X-rays of the stomach are considered safe and common research procedures, it is extremely important to prepare responsibly. Failure to comply with the doctor’s recommendations, violation of the rules for the procedure may entail obtaining biased data, the need to re-conduct the study.Why the girl has a lower abdominal pain, study the link.

How to properly prepare for a barium x-ray of the esophagus?

What is barium for?

X-ray examination of the esophagus with a contrast agent is an indicative and highly informative method for visualizing the state of the organ walls. This method of examination makes it possible with a high probability to identify pathologies in various parts of the esophagus, to assess the stage and intensity of the disease and to identify its localization.

On an empty stomach, the esophagus is a tube with collapsed walls and is poorly visualized on a roentgenogram. The data obtained with the natural contrast of the esophagus do not allow to reliably assess the state of its walls and identify diseases of various localization.

If there is air in the esophagus, only its contours appear indistinctly in the image. This is also not enough to make a correct diagnosis in many cases.

The most indicative X-ray method is an X-ray of the esophagus with contrast – a suspension of barium.This substance provides a delay in X-ray radiation and appears as a shadow on the X-ray. What does an x-ray of the esophagus with barium show? This image is more revealing and provides more information content than a conventional X-ray examination.

Barium follows the walls of the esophagus and creates the most indicative picture of the state of the esophagus, therefore, if many diseases are suspected, specialists prefer this particular diagnostic method.

It should be noted that the patient’s intake of a thick suspension of barium sulfate makes possible a leisurely study of various parts of the esophagus in various projections and positions. In this case, it is possible not only to perform fluoroscopy, but also to perform video magnetic recording.

Indications for X-ray examination with barium

There are a number of indications in which an X-ray examination of the esophagus with barium is necessary.If there is suspicion about the disease and the diagnosis, this type of diagnosis can also be carried out. We list some conditions in which it is recommended to conduct an x-ray of the esophagus with barium.

Impaired swallowing: feeling of retention of the food lump, painful sensations when swallowing food

Various disorders of the act of swallowing, the appearance of a feeling of a lump in the throat, soreness during swallowing of food may indicate an obstacle to the natural course of food when the act of swallowing is performed.The cause of this pathological condition may be the presence of a foreign body in the esophagus, thickening of its walls, or the growth of neoplasms of various origins.

An X-ray of the esophagus with barium will clearly show the location of the obstacle in a certain part of the esophagus, and also make it possible to assess its size and shape, which will help specialists in making a reliable diagnosis and choosing a rational treatment.

Chest pain, not associated with pathology of the respiratory system and cardiovascular system

If there is a history of painful sensations in the chest and with the help of differential diagnostics it was found that they have nothing to do with the cardiovascular and respiratory system, then it is possible to assume the pathology of the esophagus.Since the esophagus is located directly behind the trachea and descends down to the diaphragm and stomach, the cause of pain is likely to be localized in it.

Diseases such as hiatal hernia, esophagitis, and peptic ulcer disease can be painful and can be detected by contrast-enhanced radiography of the esophagus.

Recurrent vomiting, heartburn, belching

If the clinical picture contains symptoms such as repeated heartburn, vomiting and belching, then this may indicate a violation of the motor function of the esophagus, as well as its anatomical sphincters or the presence of various pathologies of the walls.So, this symptomatology can occur with diverticula of the esophagus, dyskinesia and achalasia. All of these diseases can be detected using an X-ray of the esophagus with barium.

Preparation for X-ray of the esophagus

Before the barium x-ray of the esophagus, some preparation should be done.

Stopping food and liquid intake 8 hours before the procedure

It is advisable to refrain from eating any food in preparation for a barium esophageal x-ray at least 8 hours before the procedure.This will provide a more accurate picture of the condition of the walls of the esophagus and prevent distortions that could be caused by food remaining in the esophagus. It will also help to avoid difficulties when the suspension of barium flows around the walls of the esophagus.

Exclusion from the diet of foods that stimulate gas formation in the gastrointestinal tract

Also, when preparing a patient for an X-ray of the esophagus with barium, it is worth excluding from the diet foods that contribute to gas formation in the organs of the gastrointestinal tract.It should be understood that air masses interfere with the acquisition of informative images, which can cause difficulties in making a diagnosis.

How is the picture taken?

Before the introduction of contrast, a survey X-ray of the area under study is made. After this, the patient is asked to take a liquid suspension of barium sulfate and a series of images are taken in various positions.


There are a number of contraindications to contrast-enhanced X-rays of the esophagus.

Pregnancy (the procedure is prescribed only for health reasons)

Barium, like X-rays, adversely affects the intrauterine development of the fetus and can lead to abnormalities in the baby. Therefore, this research method is used extremely rarely and only for health reasons.

If there is a risk of contrast injection into the respiratory system

If there is a high risk of barium suspension into the respiratory tract, which can lead to asphyxia and suffocation (for example, during fistulous passages, etc.)).

Severe condition of the patient

The extremely serious condition of the patient is also a contraindication to this study. This can only aggravate the situation.

Continuous profuse bleeding from the gastrointestinal tract

Excessive bleeding can only become more intense with the introduction of barium and with fluoroscopy.

Barium intolerance

Individual intolerance to barium can lead to the development of an immediate type of allergic reaction (loss of consciousness, Quincke’s edema and other life-threatening conditions).

Upper gastrointestinal row

For the barium meal dough in espionage, see Canary.

Upper gastrointestinal row
Synonyms Examination of the upper gastrointestinal tract, contrast radiography of the upper gastrointestinal tract, barium meal
MKB GroupMajor.minor

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, when combined 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]


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] In studies of the upper gastrointestinal tract, barium sulfate is mixed with water and swallowed orally, whereas in studies of the lower gastrointestinal tract (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-ray examinations 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]


Barium sulphate is swallowed, which is because it is a radiopaque 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, which 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]


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] The 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 the intestinal transit time. Metoclopramide is sometimes also added to the mixture to improve 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]


In this procedure, the contrast medium is continuously injected into the intestine, 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, it is necessary: ​​a laxative may also be needed to prepare and cleanse the intestines. [11] In case of enteroclysis, 500 to 1000 ml of a liquid suspension of barium sulfate is continuously injected into the intestine through the duodenum. 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 lesions to be detected that cannot be seen with other imaging techniques. [7] There is no significant difference in the detection of clinically significant results, sensitivity or specificity between enteroclases and CT enterography. [1] Enteroclysm compares favorably with wireless capsule endoscopy and two-balloon endoscopy when diagnosing pathologies of the mucous membrane of the small intestine. [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 in 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 the evaluation of Crohn’s disease patients, 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 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 of flatworms with 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 Typhlite 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 abdominal cavity 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] Leakage of barium 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 can cause 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]


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 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 Thom 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.

X-ray examination of the stomach

Fluoroscopy is a method of dynamic examination using X-rays, allows you to observe the state of internal organs in real time and choose the best projection for the picture.X-ray is the process of taking a picture of an organ on a special photographic film. Allows you to capture the image and see small details that are blurred during fluoroscopy.

An X-ray examination is prescribed if the patient has pain in the upper abdomen, difficulty swallowing, nausea, and abnormal stool (diarrhea or constipation). In most cases, in addition to the stomach itself, the esophagus and duodenum are also examined. In this case, the shape of the organs, the relief of the mucous membrane are examined, and the success of the organ’s performance of its function is also assessed.As a preparation for the study in case of intestinal malfunction, constipation, flatulence a few days before the procedure, it is recommended to switch to a slag-free diet, exclude sweets, fresh bread, milk, cabbage, soda, all fried and fatty drinks from the diet. You can eat eggs, cheeses, boiled lean meat, porridge on the water and stale bread. Also, it will not be superfluous to do a cleansing enema two to three hours before the study.

X-ray of the stomach with barium

To obtain reliable data, an X-ray of the stomach with barium is carried out only on an empty stomach, therefore it is more often prescribed in the morning hours.On the day of the examination, you cannot take medications (especially those that reduce acidity), smoking and chewing gum are prohibited, because this prevents the contrast agent from evenly enveloping the mucous membrane.

Immediately before the examination, the patient asks to drink a contrast liquid. Usually, barium sulfate is used (a thick liquid of a pale milky color with a chalk taste), and in case of individual intolerance, an iodine-containing substance. In some cases, it is necessary, in addition to the contrast, to drink a solution of soda so that the stomach is filled with air and straightened out.

During the examination, the radiologist observes the passage of contrast through the digestive tract and takes a series of images. To avoid blurring the image, you need to hold your breath for the duration of the shot. At first, the patient stands, and the stomach is translucent in an upright position from the front and to the left obliquely. Then he lies down on the X-ray table and the organs are examined horizontally. During the study, the doctor can periodically come up and press on the abdominal cavity so that the contrast is evenly distributed along the inner wall of the stomach.Usually a stomach x-ray with barium takes 20 minutes, but sometimes the procedure can be delayed.

Immediately after the examination, the patient needs to drink plenty of water to dissolve the contrast fluid – this will help to remove it from the body more easily. Drinking plenty of fluids is recommended for another day or two, as barium can sometimes lead to indigestion and constipation. Also, within a few days after the examination, the patient’s stool can be painted white or gray. The dose of radiation that the patient receives during the study is small.