What Is a Barium Swallow Procedure?
A barium swallow is a diagnostic test that involves 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; and the esophagus, stomach, and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system. You may also hear doctors refer to a barium swallow as an "upper GI series" or a "barium meal".
Parts of the Body Involved
- Esophagus
- Stomach
- Duodenum
Why Does My Child Need a Barium Swallow?
A doctor may order a barium swallow when his or her patient suffers from one of more of the following symptoms:
- Diarrhea
- Weight loss
- Abdominal pain
- Difficulty swallowing
- Regurgitation (vomiting)
- Rectal bleeding
- Bloody stools (bowel movements) or black, tarry stools
- Bloody vomit, or vomit with a "coffee-ground" consistency
A barium swallow 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
What Is It Like to Have a Barium Swallow?
Prior to the barium swallow procedure
- Review your child's medications with your doctor. There are some that your child may need to stop taking before the barium swallow procedure.
- For at least eight hours before the test, your child may not eat or drink. Smokers who are about to have a barium swallow should also refrain from smoking during that eight-hour period.
- Your child may be given a medication called glucagon to slow down the activity of the stomach and small intestine.
- Your child may be asked to swallow baking soda crystals. These will bubble and produce gas in his or her stomach, allowing for more detailed X-rays.
- If your child is going to have a small bowel follow-through, you may need to give your child a laxative medication the day before his or her exam, in order to clean out the small intestine. Check with your doctor.
During the barium swallow procedure
Your child will need to remove any jewelry, and change into a hospital gown. He or she will then drink a barium sulfate solution. This is a thick, white, chalky milkshake-like liquid that coats the inside lining of the esophagus, stomach, and duodenum.
As your child drinks the barium, a radiologist takes X-rays of the upper GI area, using a machine called a fluoroscope. If the doctor wants to examine the esophagus, he or she may have pictures taken as your child actually swallows the liquid or small bits of food that are covered with barium. Your child 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 15–30 minutes while the barium travels through the intestine.
There is usually no pain associated with the procedure, so anesthesia is not given. Some people dislike the taste of barium, while others are not bothered by it. A barium swallow can take between 30 minutes and two hours. A small bowel follow-through can take one to four hours.
After the barium swallow procedure
Your child may eat and drink as usual after his or her barium swallow. Unless your child is an inpatient at the hospital for another reason, there is no hospital stay involved.
Have your child drink lots of fluids to eliminate the barium from his or her system.
Are There Complications Associated with a Barium Swallow?
There are a few possible complications your child may encounter following a barium swallow test:
- Constipation for a few days after the barium swallow
- White stool (bowel movements)
- Bowel obstruction (rare)
- Breathing some of the barium into the lungs while trying to swallow it, which can lead to pneumonia
Certain factors increase your child's risk of experiencing complications during or after the test:
- Presence of food in the stomach
- Presence of barium in the colon
- Perforated or obstructed bowel
Due to risks of radiation exposure from the X-rays, women who are pregnant should not have a barium swallow.
What Happens Next?
A normal barium swallow will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on a barium swallow include obstructions, ulcers of the esophagus, stomach or small intestine, or irregularities in the swallowing mechanism. Your child's doctor will make treatment recommendations based on the findings.
My Child Is Not Feeling Well After the Barium Swallow. Should I Call the Doctor?
Be sure to contact your child's doctor if your child experiences any of the following:
- Abdominal pain or bloating
- Constipation doesn't resolve within a few days
- Signs of infection, including fever and chills
