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Barium Swallow

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What is a barium swallow?

A barium swallow also called an esophagogram, is an imaging test that checks for problems in your upper GI tract. Your upper GI tract includes your mouth, back of the throat, esophagus, stomach, and first part of your small intestine. The test uses a special type of x-ray called fluoroscopy. Fluoroscopy shows internal organs moving in real-time. The test also involves drinking a chalky-tasting liquid that contains barium. Barium is a substance that makes parts of your body show up more clearly on an x-ray.

Other names: esophagogram, esophagram, upper GI series, swallowing study

What is it used for?

A barium swallow is used to help diagnose conditions that affect the throat, esophagus, stomach, and first part the small intestine. These include:

  • Ulcers
  • Hiatal hernia, a condition in which part of your stomach pushes into the diaphragm. The diaphragm is the muscle between your stomach and chest.
  • GERD (gastroesophageal reflux disease), a condition in which contents of the stomach leak backwards into the esophagus
  • Structural problems in the GI tract, such as polyps (abnormal growths) and diverticula (pouches in the intestinal wall)
  • Tumours

Why do I need a barium swallow?

You may need this test if you have symptoms of an upper GI disorder. These include:

  • Trouble swallowing
  • Abdominal pain
  • Vomiting
  • Bloating

What happens during a barium swallow?

A barium swallow is most often done by a radiologist or radiology technician. A radiologist is a doctor who specializes in using imaging tests to diagnose and treat diseases and injuries.

A barium swallow usually includes the following steps:

  • You may need to remove your clothing. If so, you will be given a hospital gown.
  • You will be given a lead shield or apron to wear over your pelvic area. This protects the area from unnecessary radiation.
  • You will stand, sit, or lie down on an x-ray table. You may be asked to change positions during the test.
  • You will swallow a drink that contains barium. The drink is thick and chalky. It’s usually flavoured with chocolate or strawberry to make it easier to swallow.
  • While you swallow, the radiologist will watch images of the barium travelling down your throat to your upper GI tract.
  • You may be asked to hold your breath at certain times.
  • The images will be recorded so they can be reviewed at a later time.
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Will I need to do anything to prepare for the test?

You will probably be asked to fast (not eat or drink) after midnight on the night before the test.

Are there any risks to the test?

You should not have this test if you are pregnant or think you may be pregnant. Radiation can be harmful to an unborn baby.

For others, there is little risk of having this test. The dose of radiation is very low and not considered harmful for most people. But talk to your provider about all the x-rays you’ve had in the past. The risks from radiation exposure may be linked to the number of x-ray treatments you’ve had over time.

What do the results mean?

A normal result means that no abnormalities in size, shape, and movement were found in your throat, esophagus, stomach, or first part of the small intestine.

If your results were not normal, it may mean you have one of the following conditions:

  • Hiatal hernia
  • Ulcers
  • Tumours
  • Polyps
  • Diverticula, a condition in which small sacs form in the inner wall of the intestine
  • Esophageal stricture, a narrowing of the esophagus that can make it hard to swallow

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a barium swallow?

Your results may also show signs of esophageal cancer. If your provider thinks you may have this type of cancer, he or she may do a procedure called an esophagoscopy. During an esophagoscopy, a thin, flexible tube is inserted through the mouth or nose and down into the esophagus. The tube has a video camera so a provider can view the area. The tube may also have a tool attached that can be used to remove tissue samples for testing (biopsy).

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References

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  2. Cancer.Net [Internet]. Alexandria (VA): American Society of Clinical Oncology; 2005–2020. Esophageal Cancer: Diagnosis; 2019 Oct [cited 2020 Jun 26]; [about 3 screens]. Available from: https://www.cancer.net/cancer-types/esophageal-cancer/diagnosis
  3. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Barium Swallow; p. 79.
  4. Johns Hopkins Medicine [Internet]. Baltimore: The Johns Hopkins University; c2020. Health: Barium Swallow; [cited 2020 Jun 26]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/barium-swallow
  5. RadiologyInfo.org [Internet]. Radiological Society of North America, Inc.; c2020. Esophageal Cancer; [cited 2020 Jun 26]; [about 3 screens]. Available from: https://www.radiologyinfo.org/en/info.cfm?pg=esophageal-cancer
  6. RadiologyInfo.org [Internet]. Radiological Society of North America, Inc.; c2020. X-ray (Radiography) – Upper GI Tract; [cited 2020 Jun 26]; [about 3 screens]. Available from: https://www.radiologyinfo.org/en/info.cfm?pg=uppergi
  7. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Gastroesophageal reflux disease: Overview; [updated 2020 Jun 26; cited 2020 Jun 26]; [about 2 screens]. Available from: https://ufhealth.org/gastroesophageal-reflux-disease
  8. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Hiatal hernia: Overview; [updated 2020 Jun 26; cited 2020 Jun 26]; [about 2 screens]. Available from: https://ufhealth.org/hiatal-hernia
  9. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Upper GI and small bowel series: Overview; [updated 2020 Jun 26; cited 2020 Jun 26]; [about 2 screens]. Available from: https://ufhealth.org/upper-gi-and-small-bowel-series
  10. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2020. Health Encyclopedia: Barium Swallow; [cited 2020 Jun 26]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07688
  11. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Swallowing Study: How It Feels; [updated 2019 Dec 9; cited 2020 Jun 26]; [about 6 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/swallowing-study/abr2463.html#abr2468
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Swallowing Study: How It Is Done; [updated 2019 Dec 9; cited 2020 Jun 26]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/swallowing-study/abr2463.html#abr2467
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