Upper GI/Barium Swallow

Also called an "upper gastrointestinal (GI) series" or simply an "upper GI," upper gastrointestinal tract radiography is a flouoscopic x-ray examination of the esophagus, stomach and first part of the small intestine (also known as the duodenum). However, in order for the anatomy to show up on radiographic images, the upper gastrointestinal tract must be coated or filled with a contrast material called barium, an element that appears bright white on radiographs. The barium is given to the patient to drink. This procedure is called "upper gastrointestinal tract radiography" when the esophagus, stomach and duodenum are evaluated or a "barium swallow" when only the pharynx and esophagus are evaluated. Occasionally an additional small bowel series is requested. This evaluates the entire small bowel. Additionally, some patients are asked to swallow baking-soda crystals to create gas and further improve the images; this procedure has the modified name of "air-contrast" or "double-contrast upper GI."

An upper GI procedure is done to observe digestive function or to detect abnormalities such as ulcers, tumors or inflammation of the esophagus, stomach and duodenum. Patients who undergo this procedure are usually those who have difficulty swallowing, are complaining of chest and abdominal pain or reflux (a backward flow of partially digested food and digestive juices), or have unexplained vomiting, severe indigestion or blood in the stool (indicating internal GI bleeding).

What to expect with your procedure

The quality of the images obtained during this procedure can be degraded if the stomach is not empty of food. Therefore, you will likely be asked not to eat or drink anything (including orally administered medications, especially antacids) after midnight on the day before the examination. Nor should you chew gum or smoke after this time as these activities can increase stomach secretions that also may degrade the quality of the images.
Before the procedure begins, you will be asked to remove all jewelry and also may be asked to wear a special gown with no metal fasteners that could show up on the images.

Preparing for your procedure

This examination is usually performed on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiologic technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, 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 fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The patient and the exam table will be positioned at different angles during the course of the exam and the patient's abdomen may be compressed to help spread the barium.
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, the patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken.
If a small bowel series is part of the exam, you can expect to drink more barium and having images taken at 15 or 30 minute intervals as the barium travels the length of the small bowel.
When the examination is complete, the patient will be asked to wait until the technologist determines that the images are of high enough quality for the radiologist to read.
This exam is usually completed within 20 minutes.