Barium X-rays (Upper and Lower GI)

What are barium x-rays?

Barium x-rays (also called upper and lower GI series) are used to diagnose abnormalities of the gastrointestinal tract, such as tumors, ulcers, polyps, hernias, and strictures. With the use of barium sulfate, a mineral that x-rays cannot pass through, x-rays are taken of the area under examination.

Why are barium x-rays performed?

Reasons for performing barium x-ray procedures may include the following:

  • abdominal pain
  • bleeding from the rectum
  • blood in the vomit
  • bowel movement changes
  • chronic diarrhea or constipation
  • pain or difficulty swallowing
  • unexplained weight loss
  • unusual bloating
What are the different types of barium x-ray procedures?

There are three types of barium x-ray procedures, including the following:

  • barium enema (also called lower GI series)
  • barium swallow (also called upper GI series)
barium enema What is a barium enema?
A barium enema involves filling the large intestine with diluted barium liquid while x-ray images are being taken. Barium enemas are used to diagnose disorders of the large intestine, colon, and rectum, such as colonic tumors, polyps, and diverticula.

How is a barium enema performed?
Usually, a barium enema can be performed on an outpatient basis. The patient may be asked to do the following in preparation for a barium enema:

  • drink clear liquids the day before the exam
  • take a laxative, suppository, or drug to cleanse the bowel
  • refrain from eating and drinking after midnight on the night before the exam

These measures are done to empty the large intestine because any residue (feces) can obscure the image.

Barium enemas are performed in two ways:

  • single-contrast image - when the entire large intestine is filled with barium liquid. Single-contrast images show prominent abnormalities in the large intestine.
  • double-contrast image - when a smaller quantity of thicker barium liquid is introduced to the large intestine, followed by air. Double-contrast images show smaller surface abnormalities of the large intestine, because the air prevents the barium from filling the intestine. Instead, the barium forms a film on the inner surface.

Although each hospital may have specific protocols in place, generally, a barium enema procedure follows this process:

  1. The patient is positioned on an exam table.

  2. A rectal tube is inserted in the rectum to allow the barium to flow into the intestine.

  3. The radiologist uses a machine called a fluoroscope.
  1. During the procedure, the machine and exam table will move and the patient may be asked to move positions.
  1. After the procedure, a small amount of barium will be expelled by the body immediately. The remainder of the liquid is later excreted in the stool. Barium liquid may cause constipation. Following the exam, the patient may be asked to eat foods high in fiber and drink plenty of fluids to help expel the barium from the body.
barium small-bowel enema What is a barium small-bowel enema?
A barium small-bowel enema is also called enterocyclis. The procedure involves filling the small intestine with barium liquid while x-ray images are being taken. Barium small-bowel enemas are used to diagnose disorders of the stomach and small intestine, such as ulcers and tumors.

How is a barium small-bowel enema performed?
Usually, a barium small-bowel enema can be performed on an outpatient basis. Patients may be asked to refrain from eating or drinking after midnight on the night before the exam. An enema or laxative may be given on the day before the test to clear feces from the colon.

Although each hospital may have specific protocols in place, generally, a barium small-bowel procedure follows this process:

  1. The patient is positioned on the exam table.

  2. The radiologist uses a machine called a fluoroscope.

  3. A small tube is inserted through the mouth or nose into the stomach and small intestine. Barium is passed through the tube to the small intestine as x-ray images are taken.

  4. Following the exam, the patient may be asked to eat foods high in fiber and drink plenty of fluids to expel the barium from the body.
barium swallow What is a barium swallow?
A barium swallow, an upper GI series, is an examination of the esophagus and stomach, using barium to coat the walls of the upper digestive tract so it may be examined under x-ray. Barium swallows are used to identify any abnormalities such as tumors, ulcers, hernias, pouches, strictures, and swallowing difficulties.

How is a barium swallow performed?
Usually, a barium swallow can be performed on an outpatient basis. Patients may be advised not to eat or drink after midnight on the night before the exam.

Although each hospital may have specific protocols in place, generally, a barium swallow procedure follows this process:

  1. The patient is asked to drink the barium liquid and to swallow baking soda crystals. It is important not to belch, as the gas assists the radiologist in evaluation.

  2. The patient remains standing behind a machine called a fluoroscope.

  3. The patient may be asked to move in different positions and to hold his/her breath while the x-rays are taken.

  4. If the small intestine is to be examined, the patient may be asked to drink additional barium and a series of x-rays are taken until the barium reaches the colon.

  5. Following the exam, barium may cause constipation. The patient may be advised to drink plenty of fluids and eat foods high in fiber.
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