A barium swallow is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (a hollow tube of muscle extending from below the tongue to the stomach). The pharynx and esophagus are made visible on X-ray film by a liquid suspension called barium sulfate (barium). Barium highlights certain areas in the body to create a clearer picture. A barium swallow may be performed separately or as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and duodenum (first part of the small intestine).
Fluoroscopy is often used during a barium swallow. Fluoroscopy is a study of moving body structures—similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. In barium X-rays, fluoroscopy allows the radiologist to see the movement of the barium through the pharynx and esophagus as a person drinks.
How to prepare
You should not eat or drink anything for 6-8 hours before the test.
If you have diabetes, inform at the time of appointment.
Please bring a list of any medications you are taking when you come for your X-ray. If you usually take medication in the morning, only take it on the morning of the test if essential. If not, please wait and take any medications after the test.
You must tell your radiographer about any medicines you are taking and if you have any allergies, glaucoma or heart disease. If you are a woman of childbearing age, you will be asked if you are pregnant.
During the procedure
- If you're asked to remove clothing, you'll be given a gown to wear.
- You'll be positioned on an X-ray table that can tilt you from a horizontal to an upright position. You may also be asked to change positions (for example, lying on your side, back, or stomach) at intervals during the procedure.
- The radiologist will ask you to take a swallow of a thickened barium drink. The barium is usually flavored, although it may not be very pleasant tasting.
- As you swallow the barium, the radiologist will take single pictures, a series of X-rays, or a video (fluoroscopy) to observe the barium moving through the pharynx.
- You may be asked to hold your breath at certain times during the procedure.
- You will be given a thinner barium drink to swallow. X-rays and/or fluoroscopy will be used to observe the barium's passage down the esophagus.
- If an additional procedure called a small bowel follow-through has been requested, it will be performed after the barium swallow has been completed.
- Once all required X-rays have been taken, you'll be assisted from the table.
After the procedure
You may resume your normal diet and activities after a barium swallow, unless your physician advises you differently.
Barium may cause constipation or possible impaction after the procedure if it isn't completely eliminated from your body. You may be advised to drink plenty of fluids and eat foods high in fiber to expel the barium from the body.
Since barium isn't absorbed into the body but passes through the entire intestinal tract, your bowel movements may be lighter in color until all of the barium has been excreted.
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