Barium Swallow

Barium swallow is an X-ray examination of the upper gastrointestinal tract. It involves swallowing a solution containing barium sulfate, a metallic compound which is easily visualized on X-ray images. Barium coats the walls of the pharynx and esophagus and appears white on the images. It can be tracked as it moves through the digestive system by performing a series of X-rays. A barium swallow can help identify problems with swallowing and diagnose abnormalities of the esophagus and stomach.

Indications

Barium swallow test is used to diagnose the structural or functional abnormalities of the upper gastrointestinal tract such as:

• Swallowing disorders
• Narrowing or irritation of the esophagus
• Hiatal hernia, a defect that causes the stomach to partially slide into the chest
• Enlarged esophageal veins
• Ulcers
• Tumors
• Precancerous growths called polyps
• Gastroesophageal reflux disease or GERD

Pre-procedural preparation

You will be asked to consume a low-fiber diet for 2 to 3 days before the test. Your doctor will advise you to stop smoking if you smoke and have nothing to eat after midnight before the test. Inform your doctor if you are pregnant or allergic to any medications, latex, tape, or anesthesia. Also, inform the doctor if you have undergone any barium X-ray or bile duct radiography recently. You will be asked to remove all jewelry before the test.

Procedure

A barium swallow test is performed in the following manner:

• Standard chest and abdominal X-rays are initially performed.
• You are asked to drink about 1½ cups of the chalky barium preparation
• You will lie on an X-ray table that can be tilted from a horizontal to an upright position.
• X-rays are obtained as you swallow the preparation and while the barium passes through your digestive system.
• The table will be tilted so that the barium spreads and X-rays can be captured at various angles. Your doctor may apply pressure to the abdomen to spread the barium inside. You will be asked to swallow more of the barium preparation to obtain additional images.
• The barium swallow procedure takes about 30-60 minutes to finish.

Post-Procedural Care

Following the barium swallow procedure, you can resume a normal diet unless your doctor advises a modified diet. You may have white or light-colored stools for 1-3 days. Sufficient fluids should be consumed to help flush the barium out of your system and prevent constipation. A high-fiber diet including raw fruits and vegetables can also prevent constipation.

Risks and complications

The barium swallow is generally a safe test but as with any procedure complications may occur and can include:

• Allergic reaction or anaphylaxis
• Constipation
• Accidental entry of the barium into the windpipe

Summary

A barium swallow test uses X-ray imaging to aid in diagnosing abnormalities of the upper gastrointestinal tract. It is a safe procedure with minimal risks. Talk to your doctor about any concerns you have regarding the procedure.