Fluoroscopy - Upper GI (UGI)

What is an Upper GI Series?

An upper gastrointestinal series, or simply an upper GI, is the fluoroscopic evaluation of the esophagus, stomach and first portion of the small intestine (called the duodenum) as these structures are 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; this procedure has the modified name of an air contrast or double contrast upper GI.

What are some common uses of the procedure?

An upper GI is performed to view the function of the upper gastrointestinal tract and to identify abnormalities such as inflammation of the esophagus, stomach and proximal small intestine.  Patients who undergo this procedure usually complain of difficulty swallowing, chest or abdominal pain, reflux (a backward flow of partially digested food or digestive juices) or have unexplained vomiting, severe indigestion or blood in the stool.

How should I prepare for the procedure?

Take nothing by mouth after midnight.

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 that contains the x-ray tube and fluoroscopic equipment that will send the images to a screen in the exam room.

How does the procedure work?

A radiologist monitors the flow of barium through your gastrointestinal tract with a fluoroscope, a device that projects radiographic images in real time onto a screen in the exam room.  Still images are obtained as the barium passes through.

How is the procedure performed?

Upper GI imaging is usually scheduled in the morning to reduce your time of fasting.

A technologist will position you 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 upper gastrointestinal tract on the screen.  You may be laid down during the procedure to check, for gastroesophageal reflux.  You may be asked to hold your breath to prevent blurring of still images.

The exam is usually completed within 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.  Some discomfort may be experienced as a result of lying on the exam table, a hard surface that is typically quite cold.

After the procedure, you may resume a regular diet.  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.