Ba Swallow

Procedure Overview

What is a barium swallow
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 (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. 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).

X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a “negative” type picture is made (the more solid a structure is, the whiter it appears on the film).
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 it, hence the name barium swallow.

Indications for the Procedure
A barium swallow may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus. These abnormalities may include, but are not limited to, the following:
• cancers of the head, neck, pharynx, and esophagus
• tumors
• hiatal hernia - upward movement of the stomach, either into or alongside the esophagus
• structural problems, such as diverticula, strictures, or polyps (growths)
• esophageal varices (enlarged veins)
• muscle disorders (pharyngeal or esophageal), such as dysphagia (difficulty swallowing) or spasms (pharyngeal or esophageal)
• achalasia - the lower esophageal sphincter muscle does not relax and allow food to pass into the stomach
• gastroesophageal reflux disease (GERD) and ulcers

Barium Enema Preparation

To conduct the most accurate barium enema test, the patient must follow a prescribed diet and bowel preparation instructions prior to the test. This preparation commonly includes restricted intake of diary products and a liquid diet for 24 hours prior to the test, in addition to drinking large amounts of water or clear liquids 12–24 hours before the test. Patients may also be given laxatives, and asked to give themselves a cleansing enema.

In addition to the prescribed diet and bowel preparation prior to the test, the patient can expect the following during a barium enema:

They will be well draped with a gown as they are placed on a tilting x-ray table.
As the barium or air is injected into the intestine, they may experience cramping pains or the urge to defecate.
The patient will be instructed to take slow, deep breaths through the mouth to ease any discomfort.