What is a barium swallow?
A barium swallow, sometimes referred to as an upper GI series, or UGI, is a special x-ray study that produces what can be thought of as a snapshot or picture of the esophagus and stomach from the outside. This is in contrast to the upper endoscopy, which allows the physician to examine these structures from the inside. When the results are used together, a more complete evaluation can be obtained than if either is used alone. Put another way, the barium swallow is used to complement endoscopy in defining the anatomy of the stomach and esophagus. It is particularly useful in the evaluation of large hiatus hernias, strictures, or narrowing of the esophagus and provides some information on the ability of the esophagus to squeeze properly, as well as the stomach to empty in the expected period of time.
Before the availability of EGD, pH studies, and manometry, an upper GI series was the only test physicians had to assess the anatomy and function of the esophagus. Today, this test is used selectively and only when needed. While it can reveal valuable information in the hands of an experienced “barium radiologist,” it has limited value for diagnosing GERD in the absence of other tests.
It must be carefully noted that the UGI is NOT a test for GERD. It may suggest the possibility of GERD, but it should not mistakenly be used to diagnose this condition. Definitive diagnosis typically requires a pH study, although in approximately 20% of cases the diagnosis of GERD can be made on endoscopy.
How is the test conducted?
The study is performed as an outpatient and takes about 20 minutes to complete. It is completely painless, requires no sedation, and carries with it virtually no significant risks. You will be asked to lie on an x-ray table and drink some white, chalky liquid. As the liquid is passing through the esophagus and stomach, x-rays are taken. The liquid, or Barium, is visible on X-ray as it passes and coats the lining of the stomach and esophagus. Without the barium, a regular x-ray does not visualize these structures.
Upon completion, you are allowed to drive home and immediately resume normal diet and activities.
When will I know the results?
The results of the study are provided to you on your next physician visit or possibly over the phone from his or her office.
Reviewed by: Dr. Dengler, RefluxMD Medical Director