Upper Gastrointestinal Series

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Upper Gastrointestinal Series

(Upper GI Series; Barium Swallow; Barium Meal)

Definition

This is 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. Together, the esophagus, stomach, and duodenum are called the upper gastrointestinal (GI) tract or upper digestive system.

Upper Digestive System

Parts of the Body Involved

Esophagus
Stomach
Duodenum

Reasons for Procedure

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:

Ulcer
Blockage
Abnormal growth or tumor
Diverticula —an abnormal pouch or sac opening from a hollow organ, such as the intestine
Gastroesophageal reflux disease (GERD)
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

Food in the stomach
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.

What to Expect

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 . This will slow down the activity of the stomach and small intestine.
You may be asked to swallow baking soda crystals. These crystals will bubble and make gas in your stomach, allowing for more detailed x-rays.
If you are going to have a small bowel follow-through, you might take a laxative medication the day before your exam. This will clean out your small intestine.

Anesthesia

None

Description of the Procedure

You will remove all jewelry and wear a hospital gown. You will drink barium. Barium is a thick, white, chalky, milkshake-like liquid. It 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. Your doctor may want to look at your esophagus. So you may have pictures taken as you actually swallow the liquid or small bits of food that are covered with barium. You will change positions frequently to coat the entire surface of the GI tract with barium.

If your doctor wants to look at more of your 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.

After Procedure

You may eat and drink as usual.

How Long Will It Take?

An upper GI series can take between 30 minutes and two hours. A small bowel follow-through can take 1-4 hours.

Will It Hurt?

Possible Complications

Constipation for a few days after the procedure
White stool
Bowel obstruction, rare
Barium in your lungs, which can lead to pneumonia

Average Hospital Stay

None

Postoperative Care

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

Outcome

A normal upper GI series will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on an upper GI series include:

Obstructions
Ulcers of the esophagus, stomach, or small intestine
Irregularities in the swallowing mechanism

Your doctor will make treatment recommendations based on the findings.

Call Your Doctor If Any of the Following Occurs

After you leave the hospital, call your doctor if any of the following occurs:

Abdominal pain or bloating
Constipation doesn't resolve within a few days
Signs of infection, including fever and chills

RESOURCES:

American Gastroenterological Association
http://www.gastro.org/

National Digestive Diseases Information Clearinghouse, National Institutes of Health
http://digestive.niddk.nih.gov/

CANADIAN RESOURCES:

Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org/home.htm/

Radiology for Patients
http://www.radiologyinfo.ca/

References:

Upper GI series. National Digestive Diseases Clearinghouse, National Institutes of Health website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/uppergi/ . Published November 2004. Accessed July 19, 2008

Last reviewed November 2007 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.