Synonyms Barium Meal; GI Series; Upper GI Examination

Procedure Commonly Includes Radiographic and fluoroscopic evaluation of the esophagus, stomach, and duodenum while the patient is drinking a barium solution. Spot films will be obtained in various projections during the dynamic portion of the study. Subsequent to this, routine overhead films will also be obtained. The examination may be coupled with a study of the small bowel or may be done separately.

Indications Evaluation of the gastrointestinal tract for the presence of neoplasms, inflammatory diseases, ulcers, diverticula, obstruction, foreign body, hiatal hernia, and gastroesophageal reflux

Contraindications Presence of barium within the colon, presence of food within the stomach

Patient Preparation Adult patients should have a light, liquid supper the evening prior to the examination and should have nothing to eat or drink after midnight. Pediatric patients should refrain from eating or drinking for 4 hours prior to the examination. (The latter is at the discretion of the radiologist and depends on the age of the patient.) Some radiologists recommend a mild cathartic subsequent to the examination particularly in the case of older, chronically constipated patients.

Special Instructions Examination may be scheduled by calling the Radiology Department.

Limitations Pyelograms should be scheduled before barium studies of the GI tract. Hypotonic duodenography may be performed at the discretion of the radiologist. If the patient is scheduled to have sonographic examination of the abdomen or a CT examination, the gastrointestinal series should be delayed until these exams have been completed. High concentration of barium within the gastrointestinal tract will produce artifacts on CT scan. When the patient is scheduled for both an upper gastrointestinal series and a barium enema, the barium enema should be performed first and the patient given a cathartic such as magnesium citrate to facilitate evacuation prior to the gastrointestinal series.

Additional Information A number of different techniques are described for mucosal relief studies, double contrast examinations. There are also several different commercially available barium sulfate suspensions. In addition to this, pharmacological agents such as glucagon may be helpful in suppressing motility and facilitating hypotonic evaluation. A standard dose of 0.1 mg of glucagon diluted to 0.25 mL with sterile water is utilized routinely in some double contrast examinations.

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