Upper GI Series (Barium Swallow)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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, patients are requested not to eat or drink anything from four to eight hours before the procedure. Patients also are asked to remove their 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, by blocking 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 identify 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 maybe apparent for several days after the test.

Medically Reviewed by a Doctor on 5/20/2015

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