The gastrointestinal system is a complex body system that comprises numerous organs and tissues. It is governed by the enteric nervous system, a division of the autonomic nervous system, and it is responsible for turning food into energy and eliminating waste from the body. Because of its complexity, though, the gastrointestinal system is prone to a variety of diseases and disorders and dysfunctions. Also, because many of the symptoms of digestive problems are common, it can be difficult to diagnose without further tests. One of the tools used by doctors to make a firm diagnosis is a barium swallow test.

What Is a Barium Swallow Test?

A barium swallow test, also sometimes referred to as an upper GI series, is an imaging test performed by a radiologist that uses X-ray and fluoroscopy technology. X-rays provide doctors with a series of radiographic images that help visualize different sections of the gastrointestinal tract. A key component of a barium swallow is the introduction of a contrast medium into the body; such substances serve to increase the contrast between structures and fluids in the body. When used alongside an X-ray, the radiologist can get a much clearer picture of any abnormalities that are present.

One of the most common radiocontrast agents used for such tests is barium sulfate. Barium sulfate is an inorganic compound that has many uses in industry and technology. However, because it is insoluble in water, it also cannot be absorbed by the body. This means it lingers and its density makes it impenetrable to X-rays; as a result, it can coat various internal surfaces inside the body and make them visible on radiographs. Prior to the X-ray, the patient is asked to drink a barium sulfate suspension that easily coats the pharynx, esophagus, stomach, and bowels.

What Is a Barium Swallow Test Used to Diagnose?

As noted earlier, the gastrointestinal system is complex and can be subject to many different medical or functional problems. In some circumstances, an evaluation of the symptoms in light of family history and other factors can lead to a diagnosis. But common symptoms like diarrhea and constipation can be an indicator of so many possible conditions that other steps are needed. Below are some of the conditions that a barium swallow test may be used to diagnose or confirm:

    • Ulcers: An ulcer can be defined as any break in a bodily membrane, but the term is most often used when talking about a peptic ulcer. A peptic ulcer is a disruption or break in the wall of the stomach that can lead to numerous symptoms. A barium swallow test can confirm the location and magnitude of the break and help the doctor determine an appropriate treatment.
    • Hiatal hernia: The esophagus and stomach normally meet at an opening in the diaphragm called the esophageal hiatus. When someone has a hiatal hernia, it usually means that some of the stomach tissue has slipped through this opening into the chest cavity. This can cause pain, heartburn, and a number of other symptoms.
    • Strictures: An esophageal stricture is a narrowing or tightening of the esophagus that can result in difficulty swallowing (dysphagia) and may even be a sign of cancer. The barium swallow test can highlight any variations in the esophagus and indicate the severity of the problem.
    • Varices: Sometimes partially obstructed blood flow to the esophagus can lead to esophageal varices, an enlargement of the veins that run through the lower part of the esophagus. Varices often develop in people who have liver disease, and it can cause bleeding and other serious symptoms and complications.
    • Diverticula: Diverticula are small pouches that can form anywhere along the digestive tract but especially in the lower part of the colon. They are much more likely to form in people who are 40 and older, but they don’t typically cause serious problems unless they become inflamed or infected.
    • Cancer: Many forms of cancer that can occur along the digestive tract typically don’t present with symptoms until later stages. This can make them difficult to diagnose early on since many people don’t know they have cancer. Sometimes a barium swallow test is used to investigate another issue and only then is an abnormal growth or tumor discovered.
    • Polyps: Polyps are small, abnormal growths that typically develop on the inner lining of the colon. Although most polyps are benign, in some cases they can be a precursor to cancer. In addition to endoscopy, a barium swallow test can be used to evaluate the size and location of polyps.
    • Achalasia: Achalasia is a condition that involves the inability of certain muscle fibers to relax normally. The most common version is esophageal achalasia; the smooth muscle of the lower esophageal sphincter can fail to relax, preventing food from emptying into the stomach. Symptoms include regurgitation, chest pain, and weight loss.
    • GERD: Gastroesophageal reflux disease is a chronic condition characterized by stomach acid and stomach contents backing up into the esophagus; it is also sometimes referred to interchangeably as chronic heartburn. If left untreated, GERD can cause bleeding and scarring that may eventually interfere with the ability to swallow.

    What Is Involved in a Barium Swallow Test?

    Unlike endoscopy, which typically involves twilight sedation and feeding the endoscope down your esophagus, the barium swallow test (also known as a barium esophagram) is relatively easy to perform. You’re generally instructed to fast the night before the test is scheduled; in some cases you may be asked to avoid particular medications. The barium solution is a chalky mixture that can be unpleasant in terms of taste. A series of X-ray images are then taken as the liquid moves through your digestive system and coats various surfaces. The radiologist will be reviewing the images to look for any abnormalities.

    The whole procedure usually takes around 30 minutes. And because of how simple it is as an outpatient procedure, you’ll be able to return to a normal diet and activities immediately. One of the benefits of a barium swallow test is that it has very few side effects; some patients complain of chalky stool the next day or nausea as a result of drinking the barium liquid. If the doctor doesn’t detect any abnormalities or can’t rule out enough other conditions to make a diagnosis, other tests may be needed.

      Contact Cary Gastro About a Barium Swallow Study

      A barium swallow study is just one of the many tools available to a gastroenterologist for diagnosing problems with the digestive system. We all have gastrointestinal symptoms at times, and they’re usually mild and go away on their own. If you’ve been experiencing recurrent or worsening symptoms, or if you have noticed changes to your bowel habits, it could be an indication of a more serious condition. At Cary Gastro, we are passionate about providing excellent digestive healthcare and helping improve quality of life. To talk to a gastroenterologist, contact us today to request an appointment.