What is a barium swallow?

A barium swallow is an x-ray imaging test that helps your doctor get a detailed visual of the back of the mouth, throat and esophagus to help diagnose oral cancer or other diseases.

During a barium swallow, an x-ray will take precise images of the upper gastrointestinal tract (GI) tract as barium travels through it. The barium will help highlight any abnormalities as well as show the motion of your swallowing on the x-ray image.

Who is a candidate for a barium swallow?

A barium swallow may be able to help diagnose conditions such as:

  • Hiatal hernia — where your stomach has moved up into or beside the esophagus
  • Inflammation or blockages in the upper gastrointestinal tract
  • Benign or malignant tumors (non-cancerous and cancerous) in the head, neck, pharynx and esophagus
  • Gastric ulcers
  • Gastroesophageal reflux disease (GERD)
  • Structural conditions — conditions such as strictures (narrowing), polyps (growths), diverticula (pouches)
  • Esophageal varices — enlarged veins
  • Achalasia —medical condition where the lower esophageal sphincter won't relax to allow food into the stomach

You may not be able to have a barium swallow if you have any of the following conditions:

  • Tear or hole in the esophagus or intestines
  • Severe constipation
  • Problems swallowing that could accidentally allow barium to go into the lungs
  • You are pregnant

What are the side effects associated with a barium swallow?

Some people experience constipation or fecal impaction if the barium is not completely expelled from the body after the procedure. If you experience constipation or fecal impaction, drink plenty of fluids and eat high-fiber foods to move the barium through the digestive tract. If that doesn’t work, your doctor can prescribe a laxative.

There are also side effects associated with the radiation that is used in the test. The risks associated with radiation exposure increase as you have more x-ray exams.

If you are pregnant or suspect you are pregnant, tell your doctor. Exposure to radiation during pregnancy can cause birth defects in unborn fetuses.

What to expect during a barium swallow

A barium swallow is performed in radiology by a radiology tech. The entire procedure takes approximately 30 minutes, and you should have results within a few days.

In preparation for the procedure, your technician will position you on the x-ray table, give you a barium drink and take a series of x-rays as the barium travels through the pharynx.

Once the first set of x-rays has been taken, your technician will give you another, thinner barium drink and will take x-rays as the barium moves through the esophagus.

Barium is a chalky white substance that is used in the GI tract to help it show up on x-ray. Using barium, your doctor will be able to evaluate the size and shape of the pharynx and esophagus.

A barium swallow can be done as a standalone procedure or as a part of an upper GI series of tests that evaluate the entire upper GI tract. During this procedure, a fluoroscopy (a continuous x-ray beam) is used during a barium swallow to evaluate movement through your GI tract.

In many cases, a barium swallow accompanies an esophagogastroduodenoscopy (EGD) or as a part of an upper GI and small bowel testing.

Recovery from a barium swallow

You will go home after a barium swallow and can return to your normal activities right away. You may experience constipation or notice that your bowel movements are lighter. Once the barium has passed from the body, your bowel function should return to normal.

If you experience any of the following side effects, call your doctor right away:

  • Inability to have a bowel movement
  • Pain in the abdomen
  • Smaller than usual stools

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