Upper Gastrointestinal (GI) Series (Barium Swallow, Barium Meal)

Upper gastrointestinal (GI) series is a series of X-rays of the esophagus, stomach and duodenum during and after drinking a barium solution. The duodenum is the first part of the small intestine, and the esophagus, stomach and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system.

Parts of the body involved:

Esophagus, stomach, duodenum.

Reasons for the procedure:

• An upper GI series may be ordered if you have:
• Diarrhea
• Weight loss
• Abdominal pain
• Difficulty swallowing
• Regurgitation
• Rectal bleeding
• Bloody stools or black, tarry stools
• Bloody vomit or "coffee-ground" vomit

An upper GI series can help detect:

• An ulcer
• A blockage
• An abnormal growth or tumor
• Diverticula (an abnormal pouch or sac opening from a hollow organ, such as the intestine)
• Gastroesophageal reflux disease (GERD)
• A hiatal hernia
• Crohn's disease
• Pulmonary aspiration (inhalation of fluid, food or other foreign matter into the lungs)
• Inflammation of the stomach or small intestine

Risk factors that may lead to complications:

• Presence of food in the stomach
• Presence of barium in the colon
• Perforated or obstructed bowel
• Due to the risks of radiation exposure, you should not have an upper GI series if you are pregnant.

What to expect before the procedure:

• Review your medications with your doctor. There are some that you may need to stop taking before this procedure.
• Do not eat, drink or smoke for at least eight hours before the procedure.
• You may be given a medication called glucagon to slow down the activity of the stomach and small intestine.
• You may be asked to swallow baking soda crystals, which will bubble and produce gas in your stomach, allowing for more detailed X-rays.
• If you are going to have a small bowel follow-through, you may be asked to take a laxative medication the day before your exam to clean out the small intestine.

During the procedure:

You will be given a barium sulfate solution.

Anesthesia:

None.

Description of the procedure:

• Remove all jewelry and wear a hospital gown. You drink barium, a thick, white, chalky milkshake-like liquid that coats the inside lining of the esophagus, stomach and duodenum. As you drink the barium, the radiologist takes X-rays of the upper GI area using a fluoroscope machine. If your doctor wants to examine the esophagus, you may have pictures taken as you swallow the liquid or small bits of food covered with barium. You will be asked to change positions frequently to coat the entire surface of the GI tract with barium.
• If the radiologist wants to examine more of the small intestine, a small bowel follow-through may be done. For this exam, X-ray pictures are taken every 15 to 30 minutes while the barium travels through the intestine.

After the procedure:

You may eat and drink as usual.

How long will it take?

An upper GI series can take 30 minutes to two hours. A small bowel follow-through can take one to four hours.

Will it hurt?

No. There is usually no pain associated with the procedure.

Possible complications:

• Constipation for a few days after the procedure
• White stool
• Bowel obstruction (rare)
• Aspiration of the barium into your lungs, which can lead to pneumonia

Average hospital stay:

None.

Postoperative care:

Lots of fluids to eliminate the barium from your system.

Outcome:

A normal upper GI series will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on an upper GI series include obstructions; ulcers of the esophagus, stomach or small intestine; or irregularities in the swallowing mechanism. Your doctor will make treatment recommendations based on the findings.

Call your doctor if any of the following occurs:

• Abdominal pain or bloating
• Constipation doesn't resolve within a few days
• Signs of infection, including fever and chills