Clinical/Standard Approach to Barium Esophagus • Applied Radiology (2023)

Despite advances in gastrointestinal (GI) radiology, barium esophagography remains an indispensable technique for the detection of various morphological abnormalities of the esophagus, including nodules or plaques, ulcers, strictures, and esophageal rings. These abnormalities may be associated with radiologic findings that strongly suggest an underlying cause of the disease. However, it is not uncommon for a correct diagnosis to be made only by combining imaging findings with clinical history and presentation. Therefore, this article proposes a standard approach to esophagography based on imaging and clinical findings.


A double-contrast esophagogram is performed as a duplex exam, including single-contrast and double-contrast views of the esophagus.1After ingestion of the effervescent, the patient continuously ingested high-density barium in an upright, left posterior oblique position for double-contrast imaging of the esophagus. The double-contrast view of the gastric cardia is also obtained in the reclined position, right side down. The patient was then placed in a prone, right anterior oblique position, and asked to swallow low-dense fluid carefully to assess esophageal motility. Finally, the patient is in the prone position and swallows low-density barium continuously to optimally dilate the esophagus. The double-contrast phase of the study optimized the detection of mucosal disease, while the single-contrast phase optimized the detection of strictures due to esophageal strictures or rings.

nodules or plaques

reflux esophagitis

Reflux esophagitis is the most common inflammatory condition of the esophagus, most often presenting in double-contrast studies with a fine nodular or granular appearance due to mucosal edema and inflammation. Granularity is characterized by a continuous area of ​​disease with ill-defined radiolucency in the distal esophagus extending proximally from the gastroesophageal junction (Figure 1).1-3This finding is relatively sensitive and specific for reflux esophagitis, especially in patients with reflux symptoms such as heartburn, acid regurgitation, cough, and less commonly, dysphagia or globular sensation.3

candidal esophagitis

Candida albicansEsophagitis is the most common cause of infectious esophagitis, usually occurring as an opportunistic infection in immunocompromised patients due to diabetes, malignancy, chemotherapy, AIDS, or other causes.4,5seldom,CandidaEsophagitis is caused by stasis caused by esophageal motility disorders such as scleroderma and achalasia, which allow fungal organisms to overgrow and colonize the esophagus.6Affected individuals typically experience acute dysphagia (dysphagia), or more commonly, odynophagia (dysphagia). In some cases, the pain can be so severe that the affected person cannot swallow saliva. However, only about 50% of patients have concomitant candidiasis, so the absence of oropharyngeal disease does not exclude the diagnosis in any way.5

CandidaEsophagitis typically presents as multiple discrete plaque-like defects with intervening normal mucosa in double-contrast studies (Fig. 2A).4,5Plaques tend to involve the upper and/or middle esophagus and are linear or irregular in shape.4,5AIDS patients may develop a more violent form of candidiasis, with barium trapped between the many plaques and pseudomembranes, producing what is known asdisheveledEsophagus (Fig. 2B).5This finding can actually diagnoseCandidaEsophagitis is uncommon in modern medical practice as treatments are more effective in HIV-positive patients.


Glycogenic acanthosis is a common degenerative disease characterized by the accumulation of cytoplasmic glycogen in the squamous epithelium of the esophagus. This condition manifests as small nodules and round plaques in double-contrast studies, more commonly in the middle esophagus (Figure 3).7Glycogenic acanthosis may resembleCandidaEsophagitis, but plaques in candidiasis tend to have a linear or irregular appearance, whereas nodules in glycogenic acanthosis are more rounded. also,CandidaEsophagitis occurs in immunocompromised patients with odynophagia, whereas glycogenacanthosis occurs in immunocompromised elderly patients without esophageal symptoms. Therefore, it is almost always possible to distinguish these conditions on the basis of clinical findings.

(Video) Barium Swallow and Modified Barium Swallow (Cine)

superficial spreading carcinoma

Superficial spreading carcinoma (SCC) is a rare type of esophageal cancer in which the tumor is confined to the mucosa or submucosa, with or without nodal metastasis.8SSC typically appears in double-contrast studies as clusters of ill-defined nodules or plaques merging into one another to produce confluent areas of disease.1,8,9SSC can usually be distinguished fromCandidaEsophagitis and glycogenic acanthosis in which plaques and nodules have discontinuous borders and are separated by normal intermediate mucosa. They developed more serious diseases.

small ulcer

reflux esophagitis

Reflux esophagitis is the most common inflammation involving the esophagus. Although the mucosa is finely nodular or granular in many patients with reflux esophagitis (see previous section), more advanced disease may present with multiple small, superficial ulcerations and erosions in the distal esophagus. Ulcers are usually punctate or linear and may be accompanied by radial folds or surrounding haloes of mucosal edema (Figure 4).1Ulcers almost always develop at or near the gastroesophageal junction and extend proximally for a variable distance as a continuous area of ​​disease.1Therefore, an ulcer that does not involve the distal esophagus should suggest another cause of disease. Less commonly, reflux esophagitis may present as a single overt ulcer at or near the gastroesophageal junction. these callsmarginal ulcerThey are usually located on the posterior wall of the distal esophagus and may result from prolonged exposure to reflux acid that accumulates in the posterior esophagus due to gravity while the patient sleeps in the supine position.10

herpetic esophagitis

Herpes simplex virus type 1 is the second most common cause of infectious esophagitis in immunocompromised patients.5This condition usually presents in double-contrast studies as multiple small ulcers in the upper or middle esophagus, often surrounded by radiolucent edematous mounds (Figure 5).11,12Most patients have odynophagia, but herpetic lesions are uncommon in the oropharynx, making it difficult to differentiate from herpes and herpes.CandidaEsophagitis based on clinical findings.

Herpetic esophagitis occasionally develops as an acute, self-limited disease in otherwise healthy patients. Affected individuals develop an influenza-like syndrome including fever, headache, myalgia, and upper respiratory symptoms 7 to 10 days before the onset of severe odynophagia.13Double-comparison studies often show multiple microscopic ulcers, even smaller than those in immunocompromised patients with herpetic esophagitis, possibly because they have an intact immune system that prevents ulcer enlargement.13

drug induced esophagitis

Patients taking oral medications, particularly antibiotics such as estrocycline and doxycycline, and nonsteroidal anti-inflammatory drugs (NSAIDs), may develop focal contact esophagitis. These individuals often have acute odynophagia and a history of ingesting harmful medications with little or no water at bedtime. As a result, the capsule or tablet may become lodged in the middle of the esophagus, where it is compressed by the aortic arch or left main bronchi. Double contrast studies usually show multiple small ulcerations in the mid-esophagus (Figure 6).1,14This condition is difficult to distinguish from herpetic esophagitis on barium studies, but the clinical history can usually suggest the correct diagnosis.

Crohn's disease

Crohn's disease involving the esophagus occasionally presents as small superficial ulcers that are indistinguishable from aphthous ulcers in the small intestine or colon in patients with this disease.15,16Because esophageal Crohn's disease is almost always associated with ileocolonic disease, this diagnosis should only be considered in patients with known Crohn's disease elsewhere in the GI tract.

(Video) Radiographic Procedures: Esophagus, Stomach, and Small Intestine

large ulcer

CMV esophagitis

CMV esophagitis can manifest as one or more large flat ulcers that are indistinguishable from human immunodeficiency virus (HIV) ulcers in the esophagus (see next section).1Affected individuals typically experience dysphagia and are diagnosed with AIDS. Due to the potential toxicity of antiviral drugs such as ganciclovir, an endoscopic biopsy or culture is required to confirm the presence of CMV before initiating treatment. Although better treatment of HIV patients has reduced the number of AIDS patients, CMV esophagitis occasionally occurs in patients receiving steroids or bone marrow transplants.17-19

Anteater HIV

HIV-infected individuals may develop one or more large esophageal ulcers directly caused by the HIV virus itself, and electron microscopy of biopsy specimens reveals viral particles with morphological characteristics characteristic of HIV.20These ulcers are usually located in the lower or middle part of the esophagus and appear on barium studies as large craters (greater than 1 cm), oval or diamond-shaped, surrounded by a thin, radiolucent edematous rim (Figure 7).21,22These ulcers are indistinguishable from giant CMV ulcers in the esophagus, but most HIV ulcers heal quickly with steroid treatment.21,22In contrast, CMV ulcers require treatment with antiviral drugs. Therefore, endoscopy and biopsy are required to differentiate these infections before initiating treatment.

drug induced esophagitis

Esophagitis caused by potassium chloride, quinidine, NSAIDs, and alendronate can sometimes lead to giant esophageal ulcers, unlike tetracycline or doxycycline-induced esophagitis, which presents as small, superficial ulcers development of.23-25The clinical history usually suggests the correct diagnosis.

Barrett's esophagus

Barrett's esophagus is an acquired disorder in which progressive columnar metaplasia develops in the distal esophagus secondary to long-standing reflux disease. Barrett's esophagus occasionally presents as a single large ulcer within the columnar epithelium, occurring slightly distal to the gastroesophageal junction. Although uncommon, this finding should be highly suggestive of Barrett's esophagus in patients with hiatal hernia and gastroesophageal reflux.1,14,26

Esophageal cancer

Necrotic carcinoma of the esophagus may appear as a large ulcerated mass. In this case, barium examination may reveal a large meniscus-shaped oro-oval ulcer surrounded by an irregular thick tumor mass (Fig. 8). Produces a different radiographic appearance (see Figure 7).

ulcer simulator

Intramural pseudodiverticulosis

Intramural pseudodiverticula are dilated excretory ducts of mucous glands deep in the esophagus. Barium examination usually reveals multiple small flask-shaped pouches arranged in a longitudinal row parallel to the long axis of the esophagus (Fig. 9A).27Viewed from the front, a pseudodiverticulum can easily be mistaken for a small ulcer. Viewed from the side, however, these structures often appear to "float" outside the esophagus, whereas true ulcers communicate directly with the lumen. Some pseudodiverticula are diffuse and associated with high-grade strictures (see Figure 9A), but pseudodiverticula are more commonly seen in the distal esophagus in patients with peptic strictures (Figure 9B).27,28Although the pathogenesis is uncertain, it is hypothesized that pseudodiverticulum is the result of glandular dilatation caused by chronic inflammation. Occasionally they can also occur in alcoholism, diabetes orCandidaEsophagitis.29

(Video) What to Expect from Your Barium Swallow Test

Heterotopic gastric mucosa

>Heterotopic gastric mucosa is a common congenital anomaly not associated with Barrett's esophagus. It is usually found incidentally on the right side wall or less frequently on the left side of the upper esophagus or near the thoracic entrance, and appears in bariatric studies as a wide, flat depression with shallow indentations and lower margins in its upper portion . bottom. Figure 10).30Although this finding may be confused with a flat ulcer, its characteristic appearance and location should suggest the correct diagnosis. The vast majority of patients with esophageal heterotopia and gastric mucosa are symptomatic.

Upper and middle esophageal strictures

Barrett's esophagus

Although most strictures in Barrett's esophagus are distal to the esophagus, some patients may develop a ring or funnel-shaped stricture in the middle of the esophagus (Figure 11).26Since uncomplicated gastrointestinal strictures are almost always located a few centimeters from the gastroesophageal junction, interesophageal strictures should be highly suggestive of Barrett's esophagus in patients with hiatal hernia and reflux.26

Mediastinal irradiation

Patients receiving high-dose external beam radiation to the mediastinum may develop radiation stenosis within 4 to 8 months of stopping treatment. These strictures typically appear as long, smooth, tapered narrowings of the upper or middle esophagus, within pre-existing radiative entrances (Fig. 12).31

Esophageal cancer

Malignancies in the upper or middle esophagus are usually squamous cell carcinomas. Benign strictures typically have smooth contours and sharp edges (Figures 11 and 12), whereas malignant strictures exhibit a more irregular contour and steep shelf-like edges and are often associated with nodules and mucosal ulcers (Figure 13).1,31History is also important because patients with benign strictures have longer-lasting dysphagia and little or no weight loss, whereas patients with malignant strictures have recent onset progressive dysphagia and significant weight loss. Thus, invasive carcinoma can often be distinguished from benign strictures based on clinical and radiographic findings.

distal esophageal stricture

Digestive tract stricture

Most benign strictures of the distal esophagus are scarring caused by reflux esophagitis.28,31These induced reflux or so-calledDigestiveStenosis most commonly appears as a discrete segment (1–4 cm in length) with a smooth, tapered narrowing, almost always over a hiatal hernia (Fig. 9B). However, it is not uncommon for peptic strictures to be short (less than 1 cm long) annular constrictions at or near the gastroesophageal junction. This narrowing may be confused with Schatzkirings (Fig. 14),28,31In contrast, nasogastric intubation, Zollinger-Ellison syndrome, and alkaline reflux esophagitis can result in rapidly progressive reflux-like strictures that involve far longer distal esophageal segments than most peptic strictures.28Peptic strictures with clearly benign imaging findings are almost always considered benign, but nodular, irregular, or asymmetric strictures should be evaluated by endoscopy and biopsy to rule out malignancy.


Esophageal adenocarcinoma arises in areas of preexisting columnar metaplasia in Barrett's esophagus and thus tends to be distal to the esophagus. Advanced adenocarcinomas are usually invasive lesions that narrow the lumen and, unlike squamous cell carcinomas, have a marked propensity to invade the cardia and fundus.1These lesions typically appear on barium studies as irregular areas of luminal narrowing with shelf-like margins (Fig. 15). Occasionally, however, early-stage adenocarcinoma can be identified by nodules or irregularities in pre-existing strictures of the digestive tract.1Endoscopy and biopsy are required to rule out malignancy in these patients.

(Video) Esophageal Perforation

diffuse esophageal stricture

eosinophilic esophagitis

Eosinophilic esophagitis is an inflammatory disorder that typically occurs in children or young adults (particularly males) with longstanding dysphagia and recurrent food impactions. Affected individuals typically have a history of atopic disease, asthma, and/or peripheral eosinophilia.32In some patients, the entire thoracic esophagus has long-segment stenosis or diffuse loss of dilatation (without discrete stenosis), resulting in the so-calledSmall Bore Esophagus(Fig. 16A).33Other patients have multiple distinct annular indentations (sometimes associated with focal or diffuse esophageal strictures), producing so-calledRing esophagus(Fig. 16B).34In young men with a long history of dysphagia and atopy, a small-bore or annular esophagus should be highly suggestive of eosinophilic esophagitis.

Corrosive ingestion

Ingestion of strong acids or bases can cause severe esophagitis, leading to strictures within 1 to 3 months. Lye stenosis manifests as segmental narrowing of the upper or middle esophagus, or in advanced cases, diffuse and marked narrowing of almost the entire thoracic esophagus (Fig. 17).28,31The small-bore esophagus of eosinophilic esophagitis can produce a similar appearance (see Figure 16A), but is usually not as narrow and irregular as severe lye strictures. In problematic cases, the correct diagnosis can almost always be made based on the clinical history.

Esophageal ring

cat esophagus

The feline esophagus appears in barium studies as thin, narrow horizontal streaks extending around the circumference of the esophagus (Figure 18).35Although a feline esophagus may be discovered incidentally, it is almost always associated with gastroesophageal reflux and is usually seen during an actual reflux episode.35The characteristic appearance and transient nature of the feline esophagus allow it to be distinguished from other types of esophageal rings.

Fixed horizontal folds

Double-contrast barium studies may occasionally show fixed transverse folds in the distal esophagus with barium entrapment between the folds, producing the characteristicladderAppearance (Figure 19).36The folds are usually 2 to 5 mm wide and do not extend all the way into the esophagus.36They almost always occur in areas of peptic strictures, probably due to longitudinal scarring and shortening of the esophagus due to chronic reflux esophagitis (see Figure 19).36Unlike the feline esophagus and nonperistaltic esophageal contractions, which are transient in nature, these transverse folds are seen as a persistent finding on esophagography.36

eosinophilic esophagitis ring esophagus

As noted previously, patients with eosinophilic esophagitis may develop a distinctive annular indentation (sometimes associated with focal or diffuse esophageal strictures), forming a ring esophagus (see Figure 16).34Although the pathogenesis of rings is unknown, this presentation should be highly suggestive of eosinophilic esophagitis, especially in young men with a history of chronic dysphagia, repeated food impactions, and a history of allergies or asthma.


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  13. Short sleeve MJ, Levine MS. Herpetic esophagitis in healthy patients: clinical and imaging manifestations.Department of Radiology. 1992;182:859-861。
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  18. Moosig F, Gross WL. Esophagitis during immunosuppression.Contains rheumatoid. 2012;71:326-327。
  19. Fiegl M, Gerbitz A, Gaeta A, et al. Recovery from CMV esophagitis following allogeneic bone marrow transplantation using nonmyeloablative conditioning: the role of immunosuppression.Journal of Clinical Virology. 2005;34:219-223。
  20. Rabeneck L, Popovic M, Gartner S, et al. Acute HIV infection manifests as dysphagia and esophageal ulceration.JAMA. 1990;263:2318-2322。
  21. 21. Sor S, Levine MS, Kowalski TE, et al. Giant esophageal ulcers in human immunodeficiency virus patients: clinical, radiographic, and pathological findings.Department of Radiology. 1995;194:447-451。
  22. Levine MS, Loercher G, Katzka DA, et al. A giant ulcer in the esophagus associated with human immunodeficiency virus.Department of Radiology. 1991;180:323-326。
  23. Zographos GN, Georgiadou D, Thomas D, et al. Drug-induced esophagitis.Esophageal discomfort. 2009;22:633-637。
  24. Levine MS, Rothstein RD, Laufer I. Clinoril-induced giant esophageal ulcer.AJR Am J Ronzino. 1991;156:955-956。
  25. Ryan JM, Kelsey P, Ryan BM, Mueller PR. Esophagitis induced by alendronate: a case report of a novel severe esophagitis with esophageal stricture-imaging features.Department of Radiology. 1998;206:389-391。
  26. Ms. Levine. Barrett's esophagus: An update for radiologists.abdomen. 2005;30:133-141。
  27. Levine MS, Moolten DN, Herlinger H, Laufer I. Intramural pseudodiverticulosis of the esophagus: a reassessment.AJR Am J Ronzino. 1986;147:1165-1170。
  28. Luedtke P, Levine MS, Rubesin SE, et al. Radiographic diagnosis of benign esophageal strictures: a standard approach.Radiology. 2003;23:897-909。
  29. Cho SR, Sanders MM, Turner MA, et al. Intraesophageal pseudodiverticulosis.Radiation Gastrointestinal. 1981;6:9-16。
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What is a barium test for esophagus? ›

What is a barium swallow? A barium swallow, also called an esophagogram, is an imaging test that checks for problems in your upper GI tract. Your upper GI tract includes your mouth, back of the throat, esophagus, stomach, and first part of your small intestine. The test uses a special type of x-ray called fluoroscopy.

What happens in a barium swallow test? ›

Barium tests are used to examine the digestive tract using a white powder called barium sulphate. This powder can be seen on x-rays. For a barium swallow or barium meal, the barium sulphate powder is mixed with water (and sometimes flavouring) then swallowed. X-rays are taken as you swallow the mixture.

How much barium do you have to drink for a barium swallow? ›

The barium volume during each swallow is roughly 100 to 200 cc. The goal, typically, is to distend the esophagus for the best resolution. The contrast media may be further thinned with water if needed to reveal more subtle lesions.

What cancers can a barium swallow detect? ›

Doctors may use it specifically to diagnose esophageal (food pipe) cancer and stomach cancer, as well as head and neck cancers, including: Oral cavity (mouth) cancer. Oropharyngeal (mid-throat) cancer.

What does a barium swallow show that an endoscopy does not? ›

endoscopy. The barium swallow is a less invasive way to look at the upper GI tract than an endoscopy. Barium swallows are a useful diagnostic tool for checking for upper GI tract disorders that can be easily diagnosed with X-ray alone. More complex disorders require endoscopy.

Are you sedated for barium swallow? ›

A barium swallow is an outpatient procedure that can be performed at your doctor's office, an outpatient radiology center, or a hospital's radiology department. The test does not require sedation or anesthesia. You doctor will provide you with specific instructions to prepare for the test.

Can I drive myself home after a barium swallow test? ›

The examination is not a painful procedure. You will be able to eat and drink as normal. Barium can cause constipation, so please drink plenty of fluids and eat more fibre for a few days after the test to avoid this. You can drive home after the examination, as barium does not affect your abilities.

What should you not do before a barium swallow? ›

You will need to stop eating and drinking for about 8 hours before the swallowing test. Generally, this means after midnight. Tell your provider if you are pregnant or think you may be pregnant before scheduling a barium swallow test.

How long does it take to get results from a barium swallow test? ›

You should get the results in 1 or 2 weeks. The doctor who arranged the barium swallow gives them to you. Waiting for results can make you anxious. You can ask your doctor or nurse how long it takes to get the results.

Do you have to take your clothes off for a barium swallow? ›

Generally, a barium swallow follows this process: You'll be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.

What is best to eat after barium swallow? ›

Barium can cause constipation. To prevent this, drink plenty of clear fluids and try to eat lots of vegetables, fruit and foods high in fibre for a few days. The test results will be sent to your GP and the doctor who requested your test. It can take up to two weeks, but may be sooner.

What if I can't drink all the barium? ›

Another option for patients who cannot complete their drinking protocol is an Naso-Gastric (NG) tube - which is a thin tube inserted through the nose and threaded into the stomach. The contrast would then be administered through the NG tube.

What diagnosis would be linked to a barium swallow? ›

A barium swallow can help diagnose diseases and conditions such as GERD, ulcers, dysphagia, hiatal hernia, achalasia, tumors or cancers. As you swallow the barium contrast, a series of X-rays or an X-ray video (fluoroscopy) will show the barium moving through your upper GI tract.

What are the symptoms of a polyp in the esophagus? ›

As esophageal tumors grow, you may experience these effects:
  • Bleeding.
  • Chest pain.
  • Difficulty swallowing.
  • Food getting stuck in the back of your throat.
  • Sudden back-up of undigested food (regurgitation)
  • Ulcers (sores) in the esophagus.

What can a barium swallow help confirm a diagnosis of? ›

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.

What are the 4 stages of dysphagia? ›

Dysphagia can be classified into four categories, based on the location of the swallowing impairment: oropharyngeal, esophageal, esophagogastric, and paraesophageal (Figure 82.1). These four types occur in four separate but continuous anatomic areas.

What does it mean if you fail a swallow test? ›

Test failure is defined as the inability to drink the entire amount continuously, any cough up to 1 min after the swallowing attempt, or the development of a wet, gurgly, or hoarse vocal quality.

Which test is better barium swallow or endoscopy? ›

Should I Get a Barium Swallow or an Endoscopy for Upper GI Problems? The main advantage of a barium swallow is that it is less invasive because it's a special type of X-ray. While many patients report that swallowing the barium is unpleasant, no instruments are inserted into the body.

Does barium swallow show hiatal hernia? ›

The assessment of hiatal hernias (HH) is typically done with barium swallow X‑ray, upper endoscopy, and by high-resolution esophageal manometry (HRM).

Can a barium swallow miss a hiatal hernia? ›

A small sliding hiatal hernia may be missed by using a barium swallow or meal study.

How is a barium swallow done for GERD? ›

During a barium swallow, your doctor uses X-rays to take a close look at your back of the mouth, your pharynx, and your esophagus, the tube that runs from the back of your tongue down to your stomach. It is used to diagnose gastroesophageal reflux disease (GERD), esophageal cancer, and other issues.

Is it normal to feel sick after a barium swallow? ›

You may feel bloated or have an upset stomach for a short time after the test. Not eating before the test and the test itself may cause you to feel tired. For several days afterward, barium liquid in the GI tract causes stools to be white or light colored.

What is the difference between a barium swallow and a barium meal? ›

A barium examination of the throat and esophagus is referred to as barium swallow test. A barium examination of the stomach and the first part of the small intestine) is called a barium meal test.

Can I brush my teeth before barium swallow? ›

Can I Eat Before a Barium Swallow Test? Do not eat or drink anything, including chewing gum, for eight to 12 hours before the exam - so your stomach and upper digestive tract are completely empty. You may brush your teeth but avoid swallowing any water.

How do you prepare a patient for a barium swallow? ›

For a satisfactory exam, your stomach must be empty. It is important that you not eat or drink anything for four hours before your exam. Additionally, do not use gum, mints or cigarettes after midnight the night before your exam. If your doctor gave you an order, please bring it with you.

How toxic is barium? ›

Within 1–4 hours of ingestion, profound hypokalemia and generalized muscle weakness can develop which may progress to paralysis of the limbs and respiratory muscles. Severe hypokalemia induced by barium toxicity can cause ventricular dysrhythmias (1-7).

Can a barium swallow detect a blockage? ›

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.

Can you see esophagitis on barium swallow? ›

Barium swallow is the initial imaging modality of choice for evaluation of suspected esophageal diseases. Besides providing excellent mucosal detail, it helps in functional evaluation of esophagus and accurate diagnosis of a variety of neoplastic and non-neoplastic conditions.

Can you have a barium swallow instead of an endoscopy? ›

Chest CT or a barium swallow test appears to be a more useful and reliable diagnostic examination tool than upper GI endoscopy when screening for achalasia.

Do you have to drink the whole bottle of barium? ›

We ask that you drink all of it. You may refrigerate the contrast, but you may NOT put it on ice or mix it with anything. We understand that this is somewhat unpleasant, but it is necessary to drink both bottles in order to complete the test successfully.

Why does my stomach hurt after barium swallow? ›

You may have bloating and nausea for 1-3 days after your test. The barium will cause your stool (poop) to be white or light colored. Mild constipation from the barium is a common side effect. To avoid this, drink plenty of fluids after the exam.

How long does it take to flush out barium? ›

It's a good idea to drink a lot of fluids for a few days to flush out the barium. For 1 to 3 days after the test, your stool (feces) will look white from the barium. If the barium stays in your intestine, it can harden and cause a blockage. If you get constipated, you may need to use a laxative to pass a stool.

How long do the effects of barium last? ›

After the test, drink plenty of water to help avoid constipation and to help flush the barium out. You may have light or white stools for a few days after the test. Your stools will go back to normal color within a few days.

How fast should you drink barium? ›

Instructions for taking Oral Contrast (Barium Sulfate)

Begin drinking the contrast one and a half hours before your scheduled exam time. Drink one-third of a bottle every fifteen minutes. Save the last third and bring it with you to your appointment.

Can I drink milk instead of barium? ›

Presumably any liquid could do this, but some liquids, like water, move through the system too quickly, while barium sulfate lingers in the intestines. The researchers found that drinking whole milk before the scan has essentially the same effect, because its fat content is digested slowly.

Does barium interact with medications? ›

Barium Sulfate has no noted serious interactions with any other drugs.

Does a barium swallow show the pancreas? ›

The doctor may also ask for a "barium swallow," or "upper GI series." For this test, the patient drinks a barium solution before x-rays of the upper digestive system are taken. The barium shows an outline of the pancreas on the x-rays. Other tests may be ordered, such as: An angiogram, a special x-ray of blood vessels.

Can a barium swallow detect pancreatitis? ›

BARIUM. Barium examinations can demonstrate findings of acute pancreatitis or pathology mimicking acute pancreatitis such as peptic ulcer disease.

How serious is a polyps in the esophagus? ›

Neoplasms in the esophageal lumen can result in nutrition problems, such as anemia and cachexia. Furthermore, emergencies, such as asphyxia, may occur when the polyp enters into the airway. Esophageal polyps should be removed surgically as soon as possible after confirmation to reduce such risks.

Is it normal to have polyps in your esophagus? ›

Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size.

Are polyps in the esophagus rare? ›

Hyperplastic esophageal polyps are rare and most commonly associated with GERD.

Why would a doctor order a barium swallow? ›

A barium swallow is used to help diagnose conditions that affect the throat, esophagus, stomach, and first part the small intestine. These include: Ulcers. Hiatal hernia, a condition in which part of your stomach pushes into the diaphragm.

Is a barium swallow as good as an endoscopy? ›

Should I Get a Barium Swallow or an Endoscopy for Upper GI Problems? The main advantage of a barium swallow is that it is less invasive because it's a special type of X-ray. While many patients report that swallowing the barium is unpleasant, no instruments are inserted into the body.

Can I drive myself for a barium swallow test? ›

After the examination

You will be able to eat and drink as normal. Barium can cause constipation, so please drink plenty of fluids and eat more fibre for a few days after the test to avoid this. You can drive home after the examination, as barium does not affect your abilities.

How long does a barium swallow test take? ›

You have a barium swallow as an outpatient in the radiology (x-ray) department. It takes 10 to 15 minutes.

How do you feel after barium swallow? ›

Patients may feel nauseous after a barium swallow test or become constipated. Drinking lots of fluids can help to relieve constipation. Symptoms of nausea should improve as the barium passes through the system.

Do you have to undress for a barium swallow test? ›

Preparation before your examination

In order to achieve a successful examination, your stomach must be completely empty. You must stop eating and drinking 6 hours before your exam. You will be required to undress and remove any necklaces and earrings and to put on a hospital gown.

Do you have to stand for a barium swallow? ›

During Your Procedure

Your exam will be performed on a tilting table that will allow the procedure to be performed with you standing and lying down. You will stand for the first portion of your study and will drink a cup of liquid (barium).

Do I have to drink all the barium? ›

We ask that you drink all of it. You may refrigerate the contrast, but you may NOT put it on ice or mix it with anything. We understand that this is somewhat unpleasant, but it is necessary to drink both bottles in order to complete the test successfully.

What problems can you have after a barium swallow? ›

You may have bloating and nausea for 1-3 days after your test. The barium will cause your stool (poop) to be white or light colored. Mild constipation from the barium is a common side effect. To avoid this, drink plenty of fluids after the exam.

How does a barium swallow test show GERD? ›

Barium Swallow Test

During this procedure, you are asked to drink a harmless dose of liquid barium, which temporarily coats the lining of the esophagus, the stomach, and the intestines and is illuminated on X-rays. The barium allows a radiologist to examine these structures as the liquid goes down.

Does barium swallow show Barrett's esophagus? ›

An upper GI barium study is helpful in finding strictures (areas of narrowing), usually causing trouble swallowing. Barium studies are not useful for diagnosing Barrett's esophagus, because it is a microscopic diagnosis.


2. How to use the ASPEKT-C and ASPEKT Methods to Identify Swallowing Pathophysiology: A Tutorial
(Steele Swallowing Lab KITE - TRI - UHN)
3. Esophageal Cancer
4. Clinical: General Surgery 2 - Oesophageal Disease
(The Surgical Academy)
5. MedPix COW 2013 - Dysphagia and Trouble Swallowing
(James Smirniotopoulos)
6. An Approach to Dysphagia
(Icahn School of Medicine)


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