Upper GI Series
(Barium Swallow)
Medical Author: Jay W. Marks,
MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What is an upper gastrointestinal (GI) series?
An upper gastrointestinal
(GI) series (barium swallow), is a radiological test that is used to visualize the
structures of the upper digestive
system - the esophagus, stomach and duodenum. If it is desired to
see the remaining parts of the small intestine, a small bowel series
can be added to the test. These structures
are seen during the examination, and the images are also are
saved for further review on X-ray film or digital
images. The results of an upper GI series can reveal conditions such as
ulcers,
tumors, hiatal hernias, scarring, blockages, and abnormalities of the muscular
wall of the gastrointestinal tissues.
What are the risks of an upper GI series?
Any x-ray test procedure involves some risk from radiation
exposure. The radiation exposure is minimized by standard techniques
that have been assigned and approved by national and international
radiology committees and councils. Radiology technicians are
certified by national certifying boards.
Patients who are or may be pregnant should notify the requesting
practitioner and radiology staff, as there is potential risk of harm
to the fetus with any radiation exposure.
How does a patient prepare for an upper GI series, and how is
it performed?
A radiology technologist guides the patient through the upper
GI series along with a radiologist (a physician trained in
performing and interpreting x-rays). Because an upper GI series
involves interpreting images of the gastrointestinal system, it is
important that any materials or objects internally
or externally that could potentially interfere with interpretation of
the x-ray film be avoided. Therefore, prior to an upper GI series,
patients are requested not to eat or drink anything from four to
eight hours before the procedure. Patients also are asked to remove
extraneous clothing and all metallic objects such as jewelry.
- A patient will be positioned behind X-ray equipment called a fluoroscope for
X-ray exposure.
- The patient then is asked to swallow a liquid that contains
barium. The barium
fills and then coats the lining of the intestinal tract making the adjacent
esophagus, stomach and duodenum visible. (X-rays of the stomach and intestine
done without barium provide very little detail and information.)
- X-ray images
are obtained at different angles through the chest and abdomen. The X-ray
machine (fluoroscope) produces these images by sending X-ray radiation through
the tissues of the body to a film on the opposite side of the patient's body. As
the radiation penetrates the body, it is absorbed in varying amounts by
different body tissues.
- Due to differences in their composition, the different
organs and certain abnormalities and conditions all become visible on the X-ray
film, since they block the penetration of the X-ray beam to varying degrees.
- After development of the film, an image of the organs is revealed. The
radiologist then examines the X-rays and can define various normal and abnormal
structures of the gastrointestinal system.
- If needed, further enhancement of the different structures can be obtained by having air as well as barium in the stomach. This is accomplished by swallowing baking soda crystals.
As barium passes through the digestive system,
constipation can result,
especially in patients prone to constipation. Therefore, it generally is
advisable that patients who undergo an upper GI series
drink extra fluids after the test and consider a
laxative to relieve the bowels of the barium if the barium is
not eliminated completely within the next day or two. As it
is passing in the stool, barium has a whitish appearance that may
be apparent for several days after the test.
Next: How does the patient obtain the results of the upper GI series? »
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