What is barium and why is it used?
The stomach area does not show up very well on a normal X-ray Picture. If you swallow the barium liquid the outline of the oesophagus, stomach and small intestine show up clearly.
Barium is a soft white metal. Barium sulphate dissolves in water to form a thick white liquid. An X-ray can not scan through barium, which is why it becomes visible on an x-ray.
These tests in their own right cannot be used for diagnosing gastric reflux. This is a common misconception even with doctors around the world. The tests show structural abnormalities ie: Hiatus Hernia, swallowing problems e.c.t
There are several barium tests that can be done. You may have one or more of these tests. With each test several x-rays pictures will be taken using a low dosage of radiation. This is thought to be safe as the radiation for each test is very small.
The x-ray machine is usually linked to a TV monitor. Still pictures, or a video recording of x-ray pictures can be taken in quick succession if necessary.
For this test you will be asked to swallow the barium liquid which is usually flavoured, whilst standing in front of the x-ray machine which will monitor the progress of the liquid through your system.
The test aims to look for problems in the oesophagus (gullet) such as a stricture (narrowing), hiatus hernia, tumours, disorders of swallowing, etc.
It is usual to be asked not to eat and drink for a few hours prior.
Very similar to the barium swallow, the difference with this test is that you may be asked to lie on a couch. During the x-ray they may ask you to move around into different positions.
To ensure the barium coats around the lining of the stomach, the doctor conducting the test (radiologist) may do one or more of the following:
Ask you to swallow some bicarbonate powder and citric acid before swallowing the barium. These 'fizz up' when they mix in the stomach and produce gas. (You may have to resist the urge to burp.) The gas expands the stomach and duodenum, pushing the barium to coat their linings. This will improve the clarity of the x-ray pictures as it is the shape and contours of the stomach and duodenum linings which need to be visible.
Ask you to turn over onto your stomach. Various x-ray pictures may be taken whilst you are in different positions.
Give you an injection of a drug that makes the muscles in the stomach and gut relax.
The test is looking for problems in the stomach and duodenum such as ulcers, polyps, tumours, etc. You will be asked not to eat or drink for several hours prior to the procedure.
Barium follow through
A similar test, but in this case the X-Ray will not be started until the barium has reached the small intestines, usually around 10-15 minutes after the initial swallow.
Once started you will likely have an X-ray every 30 minutes or so until the barium has reached the large intestine (colon).
The test is used to look for problems in the small intestine.
Small intestine enema
This test is less common, although very similar to the follow through. The difference is they pass a thin tube down to your oesophagus and then pour in the barium liquid instead of you having to swallow it. It can show slightly different results to the follow through.
Other points to remember
You should tell your doctor if you are diabetic and insulin-dependant so they can correctly manage your feeding regime prior to the test without risk.
As with all procedures involving X-Rays please tell the radiologist if you are pregnant or suspect there is a chance you might be pregnant. There is a small risk that an X-rays may harm the unborn Child.
For a day or so following a Barium procedure you may find your stools are grey white in colour, this is normal. You should drink plenty of water and eat fruits, as constipation is a common problem.
If you are given an injection to relax your muscles it may cause some blurring of your vision for an hour or so afterwards. If this happens it is best not to drive.
Written by Tracey (LWR Chairman)