Fluoroscopy - Barium Swallow / Esophagram

What is a Barium Swallow?

A barium swallow, sometimes referred to as an esophagram, is the fluoroscopic evaluation of the esophagus after it has been filled with a contrast material called barium.  The patient is asked to drink the barium.  Sometimes they are also asked to swallow baking soda crystals to create gas and further improve the images.

What are some common uses of the procedure?

A barium swallow, or esophagram, is performed to view the function of the esophagus and to find abnormalities such as inflammation, stenosis (narrowing) or gastroesophageal reflux.  Patients who undergo this procedure usually have difficulty swallowing, chest pain or heartburn.

How should I prepare for the procedure?

There is no special preparation for a barium swallow.  Food and fluid intake do not need to be restricted.

Before the procedure begins you will be asked to remove all jewelry and to change into a gown, so that no metal items will show up on the images.

Women should always inform their physician or technologist if there is any possibility that they may be pregnant.

What does the equipment look like?

You will be positioned standing behind a box-like structure containing the x-ray tube and fluoroscopic equipment that will send the images to a screen in the exam room.

How does the procedure work?

The radiologist will monitor the flow of barium into through your esophagus with a fluoroscope, a device that projects radiographic images in real time onto a screen in the exam room.  Still images will are obtained as the barium passes through.

How is the procedure performed?

A technologist will position you standing next to the fluoroscopic equipment.  You may be asked to swallow baking soda crystals (sometimes called fizzies), which will create gas in your stomach.  You will be asked not to belch.  Next, you will be asked to drink barium, which resembles a light-colored milkshake.  The radiologist will instruct you when to drink and what position to turn as they view the passage of the barium through your esophagus on the screen.  You may be laid down during the procedure to check for gastroesophageal reflux.  You may also be asked to swallow a barium tablet to check for narrowing of your esophagus.  You may be asked to hold your breath to prevent blurring of still images.

The exam is usually completed within 15-20 minutes.

What will I experience during the procedure?

The liquid barium has a chalky taste.  If you receive the gas-producing crystals, you may feel the need to belch; however, hold the gas in as its presence enhances the details of the images.  You will be asked to move into different positions while standing and while lying down on the exam table.

After the procedure, the barium may color stools gray or white for 48-72 hours.  Sometimes the barium can cause constipation, which is usually taken care of by an over-the-counter laxative.  You should increase your intake of water to help flush the barium from your gastrointestinal tract.

Who interprets the results and how do I get them?

A radiologist will interpret the images, and a signed report will be sent to your physician who will discuss the results with you.