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


Definition

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. The esophagus, stomach, and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system.




Parts of the Body Involved

The upper GI tract, the esophagus, stomach, and duodenum are viewed in this procedure.

Indications

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 for Complications during the Procedure

• 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.

Prior to 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, in order to clean out the small intestine.

Description of the Procedure

Remove all jewelry and wear a hospital gown. You will drink barium, which is 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 machine called a fluoroscope. If your doctor wants to examine the esophagus, you may have pictures taken as you actually swallow the liquid or small bits of food that are covered with barium. You will be asked to change positions frequently in order 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.


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

Drink lots of fluids to eliminate the barium from your system.