What to Expect from Your Barium Swallow Test

An exam called a barium swallow test is often used to diagnose disorders that make swallowing difficult or affect the upper gastrointestinal (GI) tract (esophagus, stomach and the first part of the small intestine). The barium swallow is a special kind of X-ray test that allows the doctor to view your pharynx (the back of your mouth and throat) and your esophagus (the tube that extends from the back of the tongue to the stomach).

Basics and Conditions Diagnosed

This test involves swallowing a chalky white substance called barium, which is often mixed with water to make a thick, milkshake-like drink. When you swallow it the liquid coats the inside of your upper GI tract. Barium absorbs X-rays and appears white on X-ray images. This helps highlight what a doctor is looking at, including the inner lining of your GI tract and the motion of your swallowing, when X-rays are taken.

Common issues that the barium swallow test can help diagnose include:

• •Hiatal hernia
• •Inflammation
• •Blockages
• •Muscle disorders that could lead to spasms or trouble swallowing
• •Gastroesophageal reflux disease (GERD)
• •Ulcers
• •Cancerous or noncancerous tumors
• •Polyps (growths that usually aren’t cancerous but can grow into cancer)
• •Dysphagia (disorders of swallowing)
• •Narrowing of the esophagus
• •Abnormally enlarged veins in the esophagus that lead to bleeding

In some cases, the barium swallow is done as part of a group of X-rays that examine the entire upper GI tract. A test called fluoroscopy, which uses a continuous X-ray beam, is commonly used during a barium swallow. Another test that often comes with a barium swallow is an upper GI endoscopy.

Preparation

Your doctor may give you some dietary guidelines before your barium swallow test, and it’s important that you follow them closely if this is the case. In most cases, you aren’t supposed to eat or drink anything for six hours prior to the test, though you can take small sips of water up until two hours beforehand. If the test is combined with others, or if you have any medical conditions, your doctor may give you slightly different directions. Notify your doctor in advance if you have or have had any of these conditions:

• A perforation of the esophagus or bowel
• Bowel obstruction
• Trouble swallowing
• Severe constipation

During the Test

The steps for a standard barium swallow test will go as follows:

• •You’ll go to a local radiology facility for your test, which will be performed by a radiology technician
• •You’ll be asked to remove your clothing and any jewelry, and will change into a medical gown
• •You’ll be positioned on an X-ray table, and potentially asked to move your body around as standard X-rays are taken of your heart, lungs and abdomen
• •After this first round of X-rays, you’ll be given a barium drink to swallow
• •Either X-rays or fluoroscopy will be done to watch how the barium moves through your pharynx and you may be asked to hold your breath at times to avoid disrupting the images
• •From here, you’ll be given a thinner barium drink to swallow, and another set of X-rays or fluoroscopy will be done to watch how it moves down the esophagus

When all X-rays are complete, you’ll be finished. The test will take about 30 minutes, and there will be no restrictions to your diet or daily activities after the test unless your doctor specifies otherwise. You’ll hear from your doctor’s office within a few days to go over your test and schedule any necessary follow-up appointments.

Possible Side Effects

A barium swallow test does have some potential side effects, including constipation or fecal impaction. Drink lots of fluids and eat high-fiber foods to move the barium through your digestive tract, as these complications most often arise due to barium that remains in your body.

You may notice bowel movements that are lighter in color – once all the barium is removed from your body, this should stop. If you have trouble with bowel movements, pain or bloating in the abdomen, or stools that are smaller in diameter than usual, contact your doctor right away.

In addition, barium swallows do involve exposure to radiation from the X-ray. The risk of complications here can rise as your exposure over time does, and if you’re worried about this, you should review with your doctor all your past radiation procedures. Pregnant women should avoid barium swallow procedures, as these can cause birth defects.

Your doctor can offer additional information on a barium swallow test and can recommend it for you if it’s necessary.

Sources:

“What to Expect from a Barium Swallow.” Healthline.com. https://www.healthline.com/health/barium-swallow#overview1

“Barium Swallow.” EMedicineHealth.com. https://www.emedicinehealth.com/barium_swallow/article_em.htm