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C]Upper Gastrointestinal System (GI) Barium Studies
(Barium Swallow, Barium Meal and Barium Follow-Through]
About the procedure]
Upper gastrointestinal system barium studies are an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that performed with X-ray fluoroscopy machine and an orally ingested contrast material (barium).
The study which evaluates only the pharynx and esophagus is called a barium swallow. If stomach is included, it is called barium meal and it is called barium meal follow-through when small intestines are included.
[Indications]
An upper GI examination helps evaluate digestive function and to detect:
ulcers
tumors
inflammation of the esophagus, stomach and duodenum
hiatal hernias
scarring
blockages
abnormalities of the muscular wall of GI tissues
The procedure is also used to help diagnose symptoms such as:
difficulty swallowing
chest and abdominal pain
reflux (a backward flow of partially digested food and digestive juices)
unexplained vomiting
severe indigestion
blood in the stool (indicating internal GI bleeding)
[Patient's preparation]
To ensure the best possible image quality, patient's stomach must be empty of food. Therefore, the patient will be asked not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum and smoking after midnight on the day of the examination.
Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.
The patient may be asked to remove some or all clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any ****l objects or clothing that might interfere with the x-ray images.
[Procedure method]
This examination is usually performed on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time. This exam is usually completed between 20
minutes for barium swallow and up to two hours for barium meal follow-through. A radiologic technologist and a radiologist guide the patient through the upper GI series.
As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a fluoroscopy screen. The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review. The patient must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image.
For a double-contrast upper GI series, the patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken. When the examination is complete, the patient will be asked to wait until the radiologist determines that all the necessary images have been obtained.
Occasionally, patients find the thick consistency of the barium unpleasant and difficult to swallow. The liquid barium has a chalky taste that may be masked somewhat by added flavors such as strawberry or chocolate. Being tilted on the examination table and having pressure applied to the abdomen can be uncomfortable for some patients. The examination may also make you feel bloated. After the examination, the patient can resume a regular diet and take orally administered medications unless told otherwise by your doctor. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. ]N