Upper GI Series/ Barium Swallow

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Introduction

An Upper Gastrointestinal (GI) Series or Barium Swallow provides a set of X-rays showing the esophagus, stomach, and small intestine.  Before the X-rays are taken, barium, a chalky substance, is swallowed.  The barium provides an image of the upper gastrointestinal structures on the X-ray images.  A barium swallow is commonly used to determine the cause of pain, swallowing problems, blood stained vomit, and unexplained weight loss.  A barium swallow is an outpatient procedure that does not require sedation or anesthesia.
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Anatomy

When you eat, your tongue moves chewed food to the back of your throat.  When you swallow, the food moves into the opening of the esophagus.  Your esophagus is a tube that moves food from your throat to your stomach.  Muscles in your esophagus wall slowly squeeze the food toward your stomach. 

A ring of muscles located at the bottom of the esophagus is called the lower esophageal sphincter (LES).  The LES opens to allow food to enter the stomach.  The LES closes tightly after the food enters.  This prevents stomach contents and acids from backing up into the esophagus.

Your stomach produces acids to break down food for digestion.  Your stomach processes the food you eat into a liquid form.  The processed liquid travels from your stomach to your small intestine.

The small intestine is a tube that is about 20-22 feet long and 1 ½ to 2 inches around.  The duodenum is the first part of the small intestine.  It is a short C-shaped structure that extends off of the stomach.  The jejunum and the ileum are the middle and final sections of the small intestine.

Your small intestine breaks down the liquid even further so that your body can absorb the nutrients from the food you ate.  The remaining waste products from the small intestine travel to the large intestine.

Your large intestine, also called the large bowel, is a tube that is about 5 feet long and 3 or 4 inches around.  The first part of the large intestine, the colon, absorbs water and nutrients from the waste products that come from the small intestine.  As water is absorbed, the product becomes more solid and forms a stool.  The stool moves through the large intestine and passes out of your body when you have a bowel movement. 
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Causes

TEST USES
A barium swallow is used to view the structures of the upper gastrointestinal system.  The test is helpful for determining the cause of swallowing difficulties, pain, vomiting, and bleeding.  It can detect and diagnose conditions including polyps, tumors, cancer, ulcers, abnormalities of the esophagus, and hiatal hernia.

PREPARATION

A barium swallow is an outpatient procedure that can be performed at your doctor’s office, an outpatient radiology center, or a hospital’s radiology department.  The test does not require sedation or anesthesia.  You doctor will provide you with specific instructions to prepare for the test. 
 
Generally, the instructions include eating a restricted diet for a few days before your test and not eating or smoking for a period of time before the test.  You will need to remove all jewelry, dentures, metal hair clips, body piercing jewelry, and other items that might show up on an X-ray before your procedure.

THE PROCEDURE

You will wear an examination gown for your barium swallow procedure.  X-rays of your heart, lungs, and abdomen are taken before you swallow the barium.  You will drink 16 to 20 ounces of a barium solution.  Barium is a chalky substance that is about as thick as a milkshake.  It may take an hour or more for the barium to fill your stomach.

You will lie on your back and be secured to a table.  The table will tilt to reposition your body for the X-rays.  You may be asked to drink more barium as the process takes place.  The test may take several hours to complete.  An X-ray is a painless procedure and simply requires that you remain motionless while a picture is taken. 

After your test, you should drink lots of fluids and eat foods that are high in fiber, such as raw vegetables and fruits, to prevent constipation. Your stools may be light in color for a few days because the barium is a white substance.  Your doctor will discuss unexpected symptoms related to the test that may occur and a plan to address them.

A radiologist will read your X-rays and report the results to your doctor.  This process may take a few days.  Your doctor will contact you or schedule a follow-up appointment when the results are received.  If any abnormal results were found on your test, your doctor will discuss treatment plan options with you. 
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.