Upper gastrointestinal series

A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest.

This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner.

[2] Barium X-ray examinations are useful tools for the study of appearance and function of the parts of the gastrointestinal tract.

They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varices, ulcers, tumors, and gastrointestinal dysmotility, as well as to detect foreign bodies.

The passage of barium sulfate through the gastrointestinal tract is observed by a radiologist using a fluoroscope attached to a TV monitor.

The radiologist takes a series of individual X-ray images at timed intervals depending on the areas to be studied.

[11][12] Amongst the uses of barium swallow are: persistent dysphagia and odynophagia despite negative esophagogastroduodenoscopy (OGDS) findings, failed OGDS, esophageal motility disorder, globus pharyngis, assessment of tracheoesophageal fistula, and timed barium swallow to monitor the progress of esophageal achalasia therapy.

Water-soluble contrast agent such as Gastrografin (diatrizoate) and Conray (Iotalamic acid) is used instead of barium if oesophageal perforation is suspected.

This position is also used to check for gastroesophageal reflux when patient is asked to cough or swallow (water siphon test).

[13] Total mucosal coating of the stomach is done by asking the subject to roll to the right side into a complete circle until RAO position.

Arae gastriae in the antrum (fine reticular network of grooves) is visible if good coating is achieved.

[10] Barium is administered orally, sometimes mixed with diatrizoic acid (gastrografin) to reduce transit time in the bowel.

[12] The main aim of this study is to distend the proximal bowel through infusion of large amount of barium suspension.

This can be unpleasant to the subject, requires more staff, longer procedural time, and higher radiation dose when compared to small bowel follow-through.

The subject should be fasted overnight, any antispasmodic drugs should be stopped one day before the examination, and Tetracaine lozenges can be used 30 minutes before the procedure to numb the throat for nasojejunal tube insertion.

In a paper read in 1910 at the radiological congress they advocated for the use of barium sulfate as an opaque contrast medium in medicine.