Barium Swallow and Meal

What Is A Barium Swallow And Meal?

A Barium Study is a noninvasive medical test that helps physicians diagnose and treat medical and surgical conditions of the upper gastrointestinal tract. A Barium Swallow only evaluates the esophagus and a Barium Meal evaluates the esophagus, stomach and first part of the small intestine (duodenum).

The gastrointestinal tract does not show up very well on ordinary x-ray pictures. However, if you drink a white liquid that contains a chemical called barium, the outline of the upper GI tract shows up clearly on x-ray pictures. This is because x-rays do not pass through barium. Because barium is not absorbed into the blood, allergic reactions are extremely rare.

Images are produced using a special form of x-ray called fluoroscopy. When the upper GI tract is coated with barium, fluoroscopy makes it possible to view and assess the anatomy and function of the esophagus, stomach and duodenum.

The procedure is used to help diagnose the cause of symptoms such as difficulty swallowing, chest and abdominal pain, reflux, unexplained vomiting and blood in the stool (indicating internal GI bleeding). A Barium Meal can detect hiatus hernias, ulcers, tumors, inflammation, scarring and blockages of the esophagus, stomach and duodenum.

How should I prepare For A Barium Meal?

To ensure the best possible image quality, your stomach must be empty of food. You must therefore not to eat or drink anything (including any oral medications, especially antacids) after 22h00 the night before the examination.

The examination is usually scheduled in the morning to reduce the patient's fasting time.

You should wear comfortable, loose-fitting clothing to the exam. You will be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their doctor and x-ray department if there is any possibility that they may be pregnant. Barium studies are not recommended for pregnant women because of potential risk to the baby.

How is A Barium Meal Performed?

The radiologist and radiographer will explain and guide the patient through the examination.

An intravenous or intramuscular injection of muscle relaxant (Buscopan) may be given before the examination. Patients with glaucoma (raised pressure in eyes) should not receive Buscopan.

You will be given a glass filled with liquid barium, which resembles a light-colored milkshake, to drink. In addition to drinking barium, some patients are also given baking-soda crystals (similar to Eno´s) to further improve the images. This procedure is called a double-contrast Barium Study.

Children usually drink barium contrast material without any objection.

On occasion, some patients are given an orally ingested iodinated contrast material (Gastrograffin), which is a clear, licorice tasting liquid, instead of barium.

For example Gastrograffin could be used if a patient recently had surgery on their upper gastrointestinal tract.

The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. The radiologist will watch the barium pass through the patient's digestive tract on a fluoroscope. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. The radiologist will analyze the images and prepare a signed report for your referring doctor, who will discuss the results with you.

A Barium Meal is usually completed within 30 - 60 minutes.

What will I Experience During and After The Barium Meal?

Liquid Barium has a chalky taste. Occasionally, patients find the thick consistency of the barium unpleasant and difficult to swallow.

Being tilted on the examination table and having pressure applied to the abdomen can be uncomfortable for some patients. The examination may also make you feel bloated.

If you receive gas-producing crystals, you may feel the need to belch. However, the radiologist will tell you to try to hold the gas in (by swallowing your saliva if necessary) to enhance the detail on the x-ray images.

After the examination, you can resume a regular diet and take orally administered medications unless instructed otherwise by your doctor.

The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by a mild laxative. There is a slight chance that some barium could be retained, leading to a blockage of the digestive system. Therefore, patients who have a known obstruction in the GI tract should not undergo this examination. For any other significant changes following the exam, you should contact the radiologist or your doctor.

What Is A Barium Follow Through?

This test is similar to a barium meal but aims to look for problems in the small intestine such as malrotation, tumours and inflammatory bowel disease.

A series of x–ray images are taken at every 15 – 30 minutes or so until the barium is seen to have gone through all the small intestine and reached the large intestine (colon).

A Barium meal with follow through is usually completed in 3 hours but may take up to 8 hours to complete. Please arrange the rest of your day accordingly.

What Is A Barium Enema?

A barium enema evaluates the large intestine, also known as the colon. The rectum, appendix and a portion of the distal small intestine may also be included.

The procedure is frequently performed to help diagnose the cause of symptoms such as chronic diarrhea, blood in stools, constipation, irritable bowel syndrome, unexplained weight loss, a change in bowel habits, suspected blood loss and abdominal pain. A Barium enema may be ordered to diagnose benign tumors (such as polyps), cancer, and inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.

How Should I Prepare For The Barium Enema?

You should inform your referring physician as well as the Radiology Department if you have any allergies, especially to barium (because barium is not absorbed into the blood, allergic reactions are extremely rare). Also inform your doctor about recent illnesses, recent colon biopsies or other medical conditions (i.e. Glaucoma).

The Radiology Department will supply you with specific preparation instructions at the time you make an appointment. Read and follow the instructions exactly for the 24 hour preparation.

Our standard preparation is

Day before the procedure

• You will likely be instructed to take a laxative.
• You will also be asked not to eat and to avoid dairy products.
• Drink only clear liquids like juice, tea, black coffee, cola or broth.
• After midnight, you should not eat or drink anything.

Day of procedure

• Only water and medications are permitted on the day of the study.
• You can take your usual prescribed oral medications with limited amounts of water. Just follow your doctor's instructions.

The examination is usually scheduled in the morning to reduce the patient's fasting time.

You may be asked to remove some or all of your clothes and to wear a gown during the exam.

You may also be asked to remove jewellery and any other objects or clothing that might interfere with the x-ray images.

Women should always inform their doctor and x ray department if there is any possibility that they may be pregnant. Barium studies are not recommended for pregnant women because of potential risk to the baby.

Infants and children: Usually, there is no special preparation, but your doctor will give you detailed instructions on how to prepare your child for the examination.

How Is The Barium Enema Performed?

The patient is positioned on the examination table and an x-ray film is taken to ensure the bowel is clean.

An intravenous or intramuscular injection of muscle relaxant (Buscopan) may then be given. Patients with glaucoma (raised pressure in eyes) should not receive Buscopan – please inform the radiologist.

After performing a rectal examination, the radiologist or qualified sister will then insert a small tube into the rectum. A balloon will be inflated to hold the tube in position. A mixture of barium and water is instilled into the colon. Air may also be injected through the tube to help the barium thoroughly coat the lining of the colon.

In some circumstances, the radiologist or referring physician may prefer a water and iodine solution rather than barium.

Next, a series of x-ray images is taken. You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. During the imaging process, the patient may be repositioned frequently in order to image the colon from several angles.

Once the x-ray images are completed, most of the barium will be emptied out through the tube. The tube will be removed and the patient will be guided to the restroom. After further evacuation, another conventional x-ray film may be taken.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained

The radiologist will analyze the images and prepare a signed report for your referring physician, who will discuss the results with you.

A barium enema is usually completed within 60 minutes.

What Will I Experience During And After The Barium Enema?

As the barium fills your colon, you may feel abdominal pressure or even minor cramping. Most people tolerate this mild discomfort easily. The tip of the enema tube is specially designed to help you hold in the barium. If you are having trouble, let the radiologist know.

After the examination, you can resume a regular diet and take orally administered medications unless otherwise instructed by your doctor. You may be able to return to normal activities immediately after the examination. You will be encouraged to drink additional water for 24 hours after the examination.

Your stools may appear white for a day or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly.

What Will Barium Studies Cost?

Most Medical Aids will cover the cost of Barium studies provided that you have not exceeded your annual imaging limit. Pre – authorization is usually not required by medical aids, but please consult with your medical aid if you are uncertain.

Private patients who pay immediately with cash or with Master or Visa Cards will be charged medical aid rates.

The account remains your responsibility.

In the event of non – payment by your medical aid, you will be held liable for the account and it should be paid within 30 days