Overview of barium swallow
A barium swallow is a special type of X-ray test that helps your doctor take a close look at the back of your mouth and throat, known as the pharynx, and the tube that extends from the back of the tongue down to the stomach, known as the esophagus.
Your doctor may ask you to swallow barium to help diagnose any conditions that make it difficult for you to swallow, or if they suspect you have an upper gastrointestinal (GI) disorder.
In your upper GI tract include:
- The primary part of the small intestine called the duodenum.
To do a barium swallow, you swallow a chalky white substance known as barium. It’s often mixed with water to make a thick drink that looks like a milkshake. When it’s swallowed, this liquid coats the inside of your upper GI.
What conditions does a barium swallow help diagnose?
Your doctor may order a barium swallow to help identify a structural or functional problem in your upper GI tract. Some common problems with swallowing barium can help diagnose:
- Hyoid hernia
- Muscle defects can cause swallowing or spasms.
- Gastroesophageal reflux disease (GERD).
- Both cancerous and non-cancerous tumours.
Barium ingestion sometimes occurs as part of a series of x-rays that look into the upper gastrointestinal tract. A continuous x-ray beam called fluoroscopy is often used to capture movement through your gastrointestinal tract during a barium swallow.
How to prepare for swallow barium
It’s important to follow the dietary guidelines your doctor gives you before your procedure. You are not supposed to eat or drink anything for six hours before your procedure. You may take small sips of water up until two hours before your procedure.
If you are getting additional tests done or have any existing medical conditions, the directions your doctor gives you may be slightly different. You should notify your doctor before your procedure if you any of the following conditions:
- Esophageal or intestinal perforation
- Intestinal obstruction
- Hard to swallow
- Severe constipation
These conditions disqualify you from swallowing barium because they increase the risk of problems.
What to expect
Your doctor will prescribe your local radiology centre for your barium swallow. The procedure is performed by a trained radiology technician. From start to finish, the barium takes about 30 minutes to swallow. You will get results within a few days of your procedure.
When you are in the radiology centre, you will be asked to remove your clothing and jewellery and store your belongings in a locker. It becomes a medical gown provided by your doctor.
Your technician will place you on the x-ray table. You may be asked to move your body position while taking standard x-rays of your heart, lungs, and abdomen.
The technician will give you a barium drink to swallow. They take individual X-rays, series of X-rays or fluoroscopy to see how the barium moves through the pharynx. You may need to hold your breath at certain times to avoid any movement of the X-ray images.
Next, the technician will give you a thinner barium drink to swallow. They will again take X-rays or fluoroscopy to watch how the barium moves down the esophagus.
When all X-rays are complete, you can gather your things and leave. You can go back to your normal diet and daily activities after your barium swallow procedure unless your doctor advises otherwise.
Barium side effects
If the barium is not completely removed from your body after the procedure, it can sometimes cause constipation or a bowel effect. You need to drink plenty of fluids and eat a high fibre diet to help move the barium through your digestive system and out of your body. If that doesn’t help, your doctor may give you a laxative to move it.
After your procedure, you may notice that your stools are lighter in colour. This happens because your body does not absorb the barium. Once all the barium is removed, the stool will return to its normal colour.
If this happens, see your doctor immediately:
- You may have trouble having or not having a bowel movement.
- You may feel pain or swelling in your abdomen.
- You have stools that are smaller in diameter than usual.
Also, barium swallows involve exposure to radiation, like all X-ray procedures. The risks of complications related to radiation exposure accumulate over time and are linked to the number of X-ray exams and treatments a person receives in their life. It can be helpful to share a record of past radiation procedures with your doctor before your barium swallow.
Barium swallow versus endoscopy
Barium swallowing is a less aggressive way of viewing the upper gastrointestinal tract than endoscopy. Barium swallows are a useful diagnostic tool for detecting disorders of the upper gastrointestinal tract, which can only be easily detected with an X-ray. More complex disorders require endoscopy.