What is a barium swallow test. How does a barium swallow work. What conditions can a barium swallow diagnose. How to prepare for a barium swallow examination. What are the risks and side effects of a barium swallow. How long does it take to get barium swallow results. What alternatives exist to barium swallow tests.

Understanding the Barium Swallow Procedure

A barium swallow, also known as a cine esophagram, is a specialized radiological examination used to evaluate the upper digestive tract. This diagnostic test involves ingesting a barium-based contrast solution that coats the inner lining of the esophagus, stomach, and upper small intestine, making these structures visible on X-ray images.

How exactly does a barium swallow work? The procedure capitalizes on barium’s ability to absorb X-rays, creating a clear outline of the digestive organs on radiographic images. As the patient swallows the barium liquid, a series of X-rays are taken, allowing radiologists to observe the movement and function of the upper gastrointestinal tract in real-time.

Key Components of a Barium Swallow Test

• Barium sulfate: A chalky, white liquid that is safe to ingest and shows up clearly on X-rays
• Fluoroscopy: A type of X-ray imaging that produces real-time moving images of the internal structures
• Radiologist: A specialized physician who interprets the images and provides a diagnosis

Indications for a Barium Swallow Examination

Barium swallow tests are primarily used to investigate symptoms related to the upper digestive system. While not as common as some other diagnostic procedures, they can provide valuable insights into various conditions affecting the esophagus, stomach, and upper small intestine.

What specific conditions can a barium swallow diagnose? This test is particularly useful for identifying:

• Dysphagia (difficulty swallowing)
• Gastroesophageal reflux disease (GERD)
• Hiatal hernias
• Esophageal strictures or narrowing
• Ulcers in the upper digestive tract
• Tumors or growths in the esophagus or stomach
• Structural abnormalities of the digestive organs

In the context of oral and throat cancers, a barium swallow can help in staging mouth and oropharyngeal cancer by providing detailed images of the affected areas and surrounding structures.

Preparing for Your Barium Swallow Test

Proper preparation is crucial for obtaining accurate results from a barium swallow examination. Patients are typically required to fast for several hours before the test, with specific instructions provided in the appointment letter.

Pre-Test Instructions

1. Fasting: Avoid eating or drinking for the specified period before the test (usually 4-6 hours)
2. Medication management: Inform your healthcare provider about any medications you’re taking, as some may need to be temporarily discontinued
3. Pregnancy notification: If you are pregnant or suspect you might be, inform the radiology department before the test
4. Diabetic considerations: Special instructions may be provided for diabetic patients to manage blood sugar levels during the fasting period

What should you do if you’re unsure about the preparation instructions? It’s always best to contact the radiology department directly to clarify any questions or concerns you may have about preparing for your barium swallow test.

The Barium Swallow Procedure: Step-by-Step

Understanding what happens during a barium swallow can help alleviate anxiety and ensure a smooth examination process. The procedure is typically performed on an outpatient basis in the radiology department and takes approximately 10 to 15 minutes to complete.

Procedure Steps

1. Change into a hospital gown in a private cubicle
2. Stand in front of the X-ray machine
3. Drink the barium liquid as instructed by the radiologist or radiographer
4. Multiple X-rays are taken as you swallow and the barium moves through your digestive tract
5. You may be asked to change positions or lie down for additional images
6. The radiologist monitors the process in real-time using fluoroscopy

How does the barium liquid taste? While some patients report a chalky texture, the barium solution is often flavored to make it more palatable. The taste is generally tolerable for the short duration of the test.

Post-Procedure Care and Expectations

After completing the barium swallow test, patients can usually resume their normal activities immediately. However, there are some important considerations for the hours and days following the examination.

Post-Test Guidelines

• Resume normal eating and drinking habits
• Increase water intake to help flush the barium from your system
• Expect white or pale stools for a few days as the barium is eliminated
• Monitor for signs of constipation and increase fiber intake if needed
• Report any unusual symptoms or severe constipation to your healthcare provider

What should you do if you experience nausea after the test? While mild nausea is not uncommon, it typically subsides as the barium passes through your system. Staying hydrated and eating light, easily digestible foods can help alleviate this symptom.

Risks and Side Effects of Barium Swallow Tests

While barium swallow examinations are generally considered safe, it’s important to be aware of potential risks and side effects. The benefits of the diagnostic information gained usually outweigh these risks for most patients.

Potential Complications

• Aspiration: A small amount of barium entering the airway
• Constipation: Temporary difficulty passing stools
• Allergic reactions: Rare but possible reactions to the barium or flavoring agents
• Radiation exposure: Minimal exposure from the X-rays

How is the risk of aspiration managed during the test? Radiologists are trained to monitor for signs of aspiration, and the test can be stopped if necessary. Patients with known swallowing difficulties should inform their healthcare provider before the examination.

Interpreting Barium Swallow Results

After the barium swallow test, the radiologist analyzes the images and prepares a detailed report. This report is then sent to the referring physician, who will discuss the findings with the patient.

Result Timeframe and Follow-up

• Results are typically available within 1-2 weeks
• The referring physician will contact the patient to discuss the findings
• Additional tests or consultations may be recommended based on the results
• Patients should contact their doctor if they haven’t received results after two weeks

What information does a barium swallow report provide? The report typically includes detailed descriptions of the anatomy and function of the examined structures, any abnormalities detected, and recommendations for further evaluation or treatment if necessary.

Alternatives to Barium Swallow Tests

While barium swallow tests are valuable diagnostic tools, there are alternative procedures that may be more appropriate in certain situations. The choice of diagnostic test depends on the specific symptoms, suspected conditions, and individual patient factors.

Common Alternatives

• Endoscopy: Direct visualization of the upper digestive tract using a flexible camera
• CT scan: Cross-sectional imaging of the digestive organs
• MRI: Detailed imaging without radiation exposure
• Manometry: Measurement of muscle contractions in the esophagus
• pH monitoring: Assessment of acid reflux in the esophagus

How do healthcare providers decide between a barium swallow and alternative tests? The decision is based on factors such as the patient’s symptoms, medical history, and the specific information needed for diagnosis. In some cases, multiple tests may be recommended for a comprehensive evaluation.

In conclusion, barium swallow tests play a crucial role in diagnosing various conditions of the upper digestive tract. By understanding the procedure, its indications, and what to expect before, during, and after the test, patients can approach this diagnostic tool with confidence. As with any medical procedure, it’s essential to discuss any concerns or questions with your healthcare provider to ensure the best possible outcome and care.

Barium swallow for mouth cancer

A barium swallow is a test to look at the outline of any part of your digestive system. 

Barium is a white liquid that shows up clearly on an x-ray.  Once it is inside the body, it coats the inside of the oesophagus, stomach or bowel and shows up the outline of the organs on the x-ray.

You drink the barium liquid. Your doctor (radiologist) or radiographer then takes x-rays while you swallow the liquid. This test can show any growths or abnormal looking areas.

Barium liquid does not do you any harm and passes through your digestive system so you don’t absorb it.

Why you might have a barium swallow

This is not a very common test. You might have a barium swallow if you are having difficulty swallowing solid food.

It helps the doctor investigate the area around the voice box (larynx) and the top of the food pipe (oesophagus).

It can help doctors stage mouth and oropharyngeal cancer.

Preparing for your barium swallow

You can’t eat or drink for a few hours before the test. You’ll get an appointment letter to explain when you need to stop eating and drinking. The exact time depends on the time of your test. If you’re not sure about anything, contact the x-ray department and ask the radiographer. 

If you’re diabetic let your radiographer know. You may need to follow specific instructions. Or your appointment may need to change to suit you. 

They will tell you if you need to stop taking any medication before the test.

Contact your hospital before your appointment if you are pregnant or think you might be.

What happens

You have a barium swallow as an outpatient in the radiology (x-ray) department. It takes 10 to 15 minutes.

A radiographer or an assistant takes you to a cubicle to change out of your clothes and put on a gown.

Once you’re in the x-ray room, you stand in front of the x-ray camera. You drink some white barium liquid. This is sometimes fruit flavoured but can taste chalky.  

Your radiologist or radiographer takes a series of x-rays as the barium passes down your throat and into your stomach. They might take some x-rays with you lying down.

After the barium swallow

Once the test is over you can get dressed and go home. You can eat and drink normally.

You pass the barium out of your body in your poo. So it will look pale or white for a few days.

Barium can cause constipation. To try to prevent this, you should drink plenty of water and eat more fibre for a few days after the test. Talk to your doctor, nurse or pharmacist if you haven’t been to the toilet for a few days.

Some people feel a bit sick after a barium swallow. This should get better as the barium passes through your system.

Possible risks

A barium swallow is a safe test. It helps doctors find out what may be causing your symptoms but, as with any medical procedure, there are possible risks.  

Your doctor makes sure the benefits of having the test outweigh the possible risks.

A small amount of barium liquid can go into the airway when you drink it. Physiotherapy can help you to cough it up but most people don’t need it. Tell your doctor or radiographer before the test if you have problems swallowing.

X-rays and radiation

Exposure to radiation from x-rays can slightly increase your risk of developing cancer in the future. The amount of radiation in medical tests is low. Talk to the doctor or radiographer if you’re worried about this.

Getting your results

You should get the results in 1 or 2 weeks. The doctor who arranged the barium swallow gives them to you.

Waiting for results can make you anxious. You can ask your doctor or nurse how long it takes to get the results. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, from Monday to Friday.

• Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines
  V Paleri and N Roland
  The Journal of Laryngology & Otology, 2016, Volume 130, Supplement 2 

• ACR-SPR Practice parameter for the performance of the modified barium swallow
  American College of Radiology, 2017

• The Royal Marsden Manual of Clinical Nursing Procedures (10^th edition)
  S Lister, J Hofland and H Grafton 
  Wiley Blackwell, 2020

Last reviewed: 

01 Jun 2021

Next review due: 

01 Jun 2024

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Cary Gastroenterology Associates | Why Might I Need a Barium Swallow…

The gastrointestinal system is a complex body system that comprises numerous organs and tissues. It is governed by the enteric nervous system, a division of the autonomic nervous system, and it is responsible for turning food into energy and eliminating waste from the body. Because of its complexity, though, the gastrointestinal system is prone to a variety of diseases and disorders and dysfunctions. Also, because many of the symptoms of digestive problems are common, it can be difficult to diagnose without further tests. One of the tools used by doctors to make a firm diagnosis is a barium swallow test.

What Is a Barium Swallow Test?

A barium swallow test, also sometimes referred to as an upper GI series, is an imaging test performed by a radiologist that uses X-ray and fluoroscopy technology. X-rays provide doctors with a series of radiographic images that help visualize different sections of the gastrointestinal tract. A key component of a barium swallow is the introduction of a contrast medium into the body; such substances serve to increase the contrast between structures and fluids in the body. When used alongside an X-ray, the radiologist can get a much clearer picture of any abnormalities that are present.

One of the most common radiocontrast agents used for such tests is barium sulfate. Barium sulfate is an inorganic compound that has many uses in industry and technology. However, because it is insoluble in water, it also cannot be absorbed by the body. This means it lingers and its density makes it impenetrable to X-rays; as a result, it can coat various internal surfaces inside the body and make them visible on radiographs. Prior to the X-ray, the patient is asked to drink a barium sulfate suspension that easily coats the pharynx, esophagus, stomach, and bowels.

What Is a Barium Swallow Test Used to Diagnose?

As noted earlier, the gastrointestinal system is complex and can be subject to many different medical or functional problems. In some circumstances, an evaluation of the symptoms in light of family history and other factors can lead to a diagnosis. But common symptoms like diarrhea and constipation can be an indicator of so many possible conditions that other steps are needed. Below are some of the conditions that a barium swallow test may be used to diagnose or confirm:

• Ulcers: An ulcer can be defined as any break in a bodily membrane, but the term is most often used when talking about a peptic ulcer. A peptic ulcer is a disruption or break in the wall of the stomach that can lead to numerous symptoms. A barium swallow test can confirm the location and magnitude of the break and help the doctor determine an appropriate treatment.
• Hiatal hernia: The esophagus and stomach normally meet at an opening in the diaphragm called the esophageal hiatus. When someone has a hiatal hernia, it usually means that some of the stomach tissue has slipped through this opening into the chest cavity. This can cause pain, heartburn, and a number of other symptoms.
• Strictures: An esophageal stricture is a narrowing or tightening of the esophagus that can result in difficulty swallowing (dysphagia) and may even be a sign of cancer. The barium swallow test can highlight any variations in the esophagus and indicate the severity of the problem.
• Varices: Sometimes partially obstructed blood flow to the esophagus can lead to esophageal varices, an enlargement of the veins that run through the lower part of the esophagus. Varices often develop in people who have liver disease, and it can cause bleeding and other serious symptoms and complications.
• Diverticula: Diverticula are small pouches that can form anywhere along the digestive tract but especially in the lower part of the colon. They are much more likely to form in people who are 40 and older, but they don’t typically cause serious problems unless they become inflamed or infected.
• Cancer: Many forms of cancer that can occur along the digestive tract typically don’t present with symptoms until later stages. This can make them difficult to diagnose early on since many people don’t know they have cancer. Sometimes a barium swallow test is used to investigate another issue and only then is an abnormal growth or tumor discovered.
• Polyps: Polyps are small, abnormal growths that typically develop on the inner lining of the colon. Although most polyps are benign, in some cases they can be a precursor to cancer. In addition to endoscopy, a barium swallow test can be used to evaluate the size and location of polyps.
• Achalasia: Achalasia is a condition that involves the inability of certain muscle fibers to relax normally. The most common version is esophageal achalasia; the smooth muscle of the lower esophageal sphincter can fail to relax, preventing food from emptying into the stomach. Symptoms include regurgitation, chest pain, and weight loss.
• GERD: Gastroesophageal reflux disease is a chronic condition characterized by stomach acid and stomach contents backing up into the esophagus; it is also sometimes referred to interchangeably as chronic heartburn. If left untreated, GERD can cause bleeding and scarring that may eventually interfere with the ability to swallow.

What Is Involved in a Barium Swallow Test?

Unlike endoscopy, which typically involves twilight sedation and feeding the endoscope down your esophagus, the barium swallow test (also known as a barium esophagram) is relatively easy to perform. You’re generally instructed to fast the night before the test is scheduled; in some cases you may be asked to avoid particular medications. The barium solution is a chalky mixture that can be unpleasant in terms of taste. A series of X-ray images are then taken as the liquid moves through your digestive system and coats various surfaces. The radiologist will be reviewing the images to look for any abnormalities.

The whole procedure usually takes around 30 minutes. And because of how simple it is as an outpatient procedure, you’ll be able to return to a normal diet and activities immediately. One of the benefits of a barium swallow test is that it has very few side effects; some patients complain of chalky stool the next day or nausea as a result of drinking the barium liquid. If the doctor doesn’t detect any abnormalities or can’t rule out enough other conditions to make a diagnosis, other tests may be needed.

Contact Cary Gastro About a Barium Swallow Study

A barium swallow study is just one of the many tools available to a gastroenterologist for diagnosing problems with the digestive system. We all have gastrointestinal symptoms at times, and they’re usually mild and go away on their own. If you’ve been experiencing recurrent or worsening symptoms, or if you have noticed changes to your bowel habits, it could be an indication of a more serious condition. At Cary Gastro, we are passionate about providing excellent digestive healthcare and helping improve quality of life. To talk to a gastroenterologist, contact us today to request an appointment.

Author

Mane Ideas

What an x-ray of the stomach with barium shows

In diseases of the gastrointestinal tract, a number of examinations are performed. Among them, x-ray of the stomach, gastroscopy, ultrasound, tomography, fluoroscopy. In this article, we will look at what an X-ray of the stomach with barium shows, what is better than an X-ray of the stomach or FGDS, how and why these procedures are performed. X-ray of the upper gastrointestinal tract is prescribed if the doctor suggests a stomach ulcer, gastritis, neoplasms in the form of a tumor, polyps, and a hernia of the stomach. And also this is an indispensable study in case of suspected presence of a foreign body.

What does the diagnosis show?

Examination allows diagnosing inflammatory processes, displacement or prolapse of the stomach, changes in its size, diverticula, as well as assessing the condition of the walls of the stomach. The procedure is carried out with barium, since this drug reflects X-rays and makes it possible to assess the state of the digestive system, to see their size, structure and integrity. If a hernia of the esophageal opening of the diaphragm is suspected, a series of examinations is carried out. Among them, an x-ray on HH, which allows you to establish the area where the patency is impaired and differentiate the hernia from other pathologies that have similar symptoms.

If you are concerned about any health problem, sign up for a diagnosis. The success of treatment depends on the correct diagnosis.

How is an x-ray of the stomach and esophagus done with barium?

Many people are interested in what and how they drink with an X-ray of the stomach with barium. For diagnostics, barium sulfate is used, the drug is taken orally, dissolving in water. It is completely safe for the body, looks like a white suspension, tastes like chalk or calcium. The first shot is taken before barium is consumed. Then the patient drinks a few sips of the drug and begins the study of the esophagus. After a few minutes, the patient drinks the solution, after which the radiologist continues to examine the stomach, taking pictures as the barium moves. During the diagnosis, the patient is asked to lie on the table and periodically change position, following the instructions of the doctor. For a clearer image, the radiologist may ask the patient to hold their breath at the time of exposure. The study lasts from 20 minutes to an hour. Next, the doctor examines a series of images and writes a conclusion.

When diseases are detected, many patients are interested in how often they can take x-rays, waiting for a re-examination appointment. There is no single answer to this question, since the doctor, choosing a diagnostic method, is guided by the individual circumstances of a particular patient. Age, condition, radiation dose and the feasibility of the procedure are taken into account.

Which is better gastroscopy or stomach x-ray?

A more popular examination of the esophagus is gastroscopy. Gastroscopy, also known as FGDS, is an endoscopic examination of the upper gastrointestinal tract. The study is carried out using an endoscope by inserting it through the mouth, which makes the procedure extremely unpleasant. The advantage of gastroscopy is higher information content compared to radiography and the absence of radiation. In addition, if necessary, the doctor can take a tissue sample for further histological analysis right during the EGD. In fact, diagnostics have different purposes and it is advisable to carry out both. The results of the survey complement each other and give a complete picture of the state of the esophagus, stomach and duodenum.

This article is posted for educational purposes only, does not replace a doctor’s appointment and should not be used for self-diagnosis.

February 11, 2019

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X-ray examinations

X-ray examinations GAUZ SO City Clinical Hospital No. 40 2 What is a stomach fluoroscopy?

Fluoroscopy of the stomach – x-ray examination of the pharynx, esophagus, stomach and duodenum with a contrast agent (barium).

This is an X-ray examination method. The dose of ionizing radiation received by the patient is small. The advantage of fluoroscopy is the ability to evaluate not only the anatomy, but also the function of organs: when you swallow a portion of a contrast agent, the radiologist observes not only the structure, but also the function of the esophagus, stomach, duodenum. In some cases, in addition to the contrast agent (suspension of barium sulfate), you are given an effervescent solution to drink so that the organs fill with air.

Can everyone get x-rays?

Pregnant women should not be tested because X-ray radiation can adversely affect the fetus.

Tell your doctor if you are allergic to barium or iodine contrast media.

How to prepare for the examination?

In order for the study to be successful, of high quality, you must come with an empty stomach. Therefore, before the study:

1. Do not eat
2. Do not drink
3. Do not take medicines, especially antacids (acid reducers)!
4. Do not chew gum or gummies
5. Do not smoke after midnight

How is the study going?

You will be asked to partially undress, remove jewelry, dentures, glasses, and any metal objects that may be in the path of the X-ray beam. The laboratory assistant will help you to make yourself comfortable. You will be told how to swallow barium sulfate. Barium sulfate (colloquially – barium) – a contrast agent, absolutely tasteless, the density resembles a thick milkshake. The radiologist will monitor the passage of the barium in real time, in addition, he will take several x-rays, for this you will be asked to hold your breath. The radiologist can put pressure on your stomach to assess the passage of barium, its entry into different parts of the stomach.

In some cases, you will additionally be asked to drink an effervescent liquid so that the gas will stretch the stomach and straighten its walls.

Examination time 15-20 minutes.

When will I get my result?

It usually takes the doctor 1-2 hours to evaluate the test results, but in difficult cases it can take up to 24 hours. The legislation of the Russian Federation (Order of the Ministry of Health and Social Development No. 132) is given 24 hours to write a protocol and provide an opinion. This order provides for the doctor’s opportunity to consult with colleagues, to contact the attending physician and provides time to consult the literature. Therefore, if you do not want to wait, it would be better to come the next day, at any time convenient for you, and pick up the results.

Irrigoscopy is an x-ray examination of the intestine, in which a contrast agent is injected through the rectum. The study allows to identify polyps, obstruction, perforation and tumor formations.

Preparation for the study

Preparation for the study is a necessary and most important aspect of a successful implementation and includes: diet for 2 days + drug preparation on day 3 (on the eve of the study).

1, 2 day: diet

Exclude: grains, nuts, legumes, fresh and dried fruits and vegetables, dairy products, fatty meats and fish, mushrooms, condiments, alcoholic and carbonated drinks, smoked meats, canned food.

Allowed: flour products without additives (raisins, poppy seeds, whole grains, etc.), cereals, eggs, low-fat meats and fish, mashed potatoes, kissels, clear juices, broths, scrambled eggs, honey, weak tea and coffee, still water.

Day 3: liquids + drug preparation

Avoid all solid foods.

It is allowed to take any clear liquids in unlimited quantities (broths, tea, coffee, juices without pulp, water).

In our clinic, we recommend preparing for the study with preparations based on polyethylene glycol (Moviprep, Fortrans). The regimen of the drug depends on the time of the study.

If there are contraindications to the use of polyethylene glycol preparations, check the preparation schedule with your doctor (individually).

Bring with you:

1. Referral from the attending physician
2. Results of sigmoidoscopy
3. Results of previous examinations
4. Drape

Is it possible for everyone to have barium enema ?

Pregnant women should not be tested because X-ray radiation can adversely affect the fetus.

How is the procedure?

You will be asked to partially undress, remove jewelry, dentures, glasses, and any metal objects that may be in the path of the X-ray beam. The technician will help you lie down comfortably on the X-ray table. A catheter will be inserted into your rectum and through it the intestine will be filled with a suspension of barium sulfate – a contrast agent. They’ll take some x-rays. The bowel will then be inflated with air so that the bowel walls can be assessed, and several more x-rays will be taken. At this time, you will have discomfort from stretching the intestines with air. The entire procedure takes 30-45 minutes.

You will then have a bowel movement. You may have a few more x-rays.

After examination:

For 3 days we recommend drinking plenty of fluids to speed up the elimination of the contrast from the intestines. The contrast agent is not absorbed in the intestines and has no effect on the body.

When will I get my result?

It usually takes the doctor 1-2 hours to evaluate the test results, but in difficult cases it can take up to 24 hours. The legislation of the Russian Federation (Order of the Ministry of Health and Social Development No. 132) is given 24 hours to write a protocol and provide an opinion. This order provides for the doctor’s opportunity to consult with colleagues, to contact the attending physician and provides time to consult the literature. Therefore, if you do not want to wait, it would be better to come the next day, at any time convenient for you, and pick up the results.

Hysterosalpingography.

Hysterosalpingography is an x-ray examination of the uterus and fallopian tubes with the introduction of a contrast agent, which allows you to evaluate their patency.

For patients.

Phone for appointment (343) 2669772

Examination is carried out from the 7th to 12th or 15th to 22nd day of the cycle cycle

You must have with you :

1. Referral from the attending physician
2. The results of a swab examination for flora not more than 10 days old
3. Diaper, sheet.
4. Sanitary napkin
5. Change of footwear

How to prepare for the examination?

• The perineum needs to be shaved
• Bowel preparation – in the morning a separate chair, or a cleansing enema, or a rectal suppository with glycerin.
• Light breakfast.
• From the beginning of the menstrual cycle until the time of the study, barrier contraception to exclude pregnancy.

How is the study carried out?

You will be asked to undress from the waist down. The technician will help you lie comfortably on the X-ray table, on your back with your knees bent. A catheter will be inserted into the vagina and the cavity of the uterus and fallopian tubes will be filled with a contrast agent. You may experience slight discomfort, this is normal. The doctor will then take an x-ray. The catheter will then be removed. You may experience discomfort in the lower abdomen for 1-2 days, this is normal, but if the pain is intense, tell your doctor about it.