What Is Barium Swallow Test?

Barium swallow can diagnose GERD, heartburn, hiatal hernias, and other conditions.

A barium swallow is a test that may be used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, bloodstained vomit, or unexplained weight loss.

Barium sulfate is a metallic compound that shows up on X-rays and is used to help see abnormalities in the esophagus and stomach. When taking the test, you drink a preparation containing this solution. The X-rays track its path through your digestive system.

These problems can be detected with a barium swallow:

• Narrowing or irritation of the esophagus (for example, Schatski's ring)
• Disorders of swallowing (dysphagia - difficulty swallowing), spasms of the esophagus or pharynx
• Hiatal hernia (an internal defect that causes the stomach to slide partially into the chest)
• Abnormally enlarged veins in the esophagus (varices) that cause bleeding
• Ulcers
• Tumors
• Polyps (growths that are usually not cancerous, but develop into cancer)
• Gastroesophageal reflux disease (GERD)

A barium swallow is generally a safe test, but like any procedure, there are occasionally complications. Your doctor should be advised of problems so you can be treated right away. Following are some of these complications:

• Allergic reaction or anaphylaxis may occur in people who are allergic to the barium drink.
• Constipation may develop.
• You may accidentally get barium into the trachea (windpipe). The medical term for this is aspiration.

• Learn about the barium swallow exam: who will perform it, where it will be performed, and how long it will take.
• Home care: You may be asked to eat a low-fiber diet for 2 to 3 days before the barium swallow test. You will be asked not to eat or smoke after midnight before the exam.
• Before the barium swallow test: You will wear a hospital gown and told to remove all jewelry including body jewelry such as nipple and belly-button rings, dentures, hair clips, or other objects that might show up on an X-ray. You will receive a form requesting your consent to perform the test. Read this form carefully. You should make sure that you understand the form and agree with it before signing it. Ask your doctor any questions you have before you sign the form.

Do not hesitate to discuss with the technicians any questions or concerns you may have before, during, or after the barium swallow test.

• You will drink about 1 1/2 cups of a barium preparation-a chalky drink with the consistency (but not the flavor) of a milk shake. Children will drink less.
• The barium can be seen on an X-ray as it passes through the digestive tract.
• The barium swallow procedure may take about 30 minutes to finish. In certain cases, it may take up to 60 minutes to fill the stomach.
• You will be strapped securely on your back on a table that tilts forward. X-rays to examine your heart, lungs, and abdomen will be taken before you drink the barium. You then will be asked to swallow the barium mixture.
• X-rays will be taken again as the barium moves through the digestive system. You will be asked to take more swallows so more pictures can be taken.
• As the barium moves down your digestive system, the table will be tilted at various angles to help spread the barium for different views. Pressure may be applied to your abdomen to spread the barium. Finally, you will be placed horizontally, asked to take a few more swallows of barium, and X-rayed again.

When you return home, you can resume your normal diet unless you are advised otherwise by your doctor. Because the barium is white, your stools will be chalky and light-colored for 1 to 3 days. Do not be concerned about this.

• You should try to drink lots of fluids to help alleviate the constipation.
• Eat food with lots of roughage and fiber such as raw fruits and raw vegetables.

Ask your doctor for the results of your barium swallow test. You may have to wait a few days until the radiologist (a specialist in X-ray examinations) looks at the X-rays and gives your doctor the final results. Your doctor will recommend a plan of action based on the results.

• The x-rays will show the digestive wave (peristalsis) through the length of the esophagus. When barium reaches the end of the esophagus, the barium enters the stomach.
• The barium swallow may reveal problems in the pharynx (the back of the throat), the esophagus, or the stomach. The problems could be narrowing, tumors, polyps, ulcers (erosions), or disorders in moving food through the system. It can also show a hiatal hernia, diverticula (pouches opening along the esophagus), or varices (enlarged veins).
• If the barium swallow test shows any area of concern, your doctor may plan what other tests, procedures, treatments, or medications you may need. The treatment for problems discovered during a barium swallow vary depending on the condition.

Call your doctor if you have any unusual problems after the barium swallow test, such as vomiting, bleeding, pain, or trouble breathing. If you do not have a bowel movement in 2 to 3 days after the test, you should also call or see your doctor.

You should go to the hospital's emergency department if you have severe pain, difficulty breathing, constant vomiting, chest pain, or any other symptoms that you think might be an emergency.