A barium swallow is a type of test used to look inside the esophagus, or food pipe. A doctor might recommend this test if they need to look at the outline of any part of a person’s digestive system.
Barium is a white liquid that is visible on X-rays. Barium passes through the digestive system and does not cause a person any harm.
As it passes through the body, barium coats the inside of the food pipe, stomach, or bowel, causing the outlines of the organs to appear on X-ray.
A barium swallow test may be used if someone has any of the following conditions:
- frequent, painful heartburn
- gastric reflux, where food or acid keeps coming back up the food pipe
- difficulty eating, drinking, or swallowing
This test can give a doctor information about how the person is swallowing.
It can also reveal if someone has any of the following in their food pipe, stomach, or the first part of the bowel:
- abnormal growths
If someone has a tumor, this will show up on the X-ray as an irregular outline that extends from the wall of the affected organ.
People who are undergoing a barium swallow should not eat or drink for a few hours before the test. In some cases, the doctor may ask the person to stop taking medication before the test.
Some hospitals recommend not chewing gum, eating mints, or smoking cigarettes after midnight the night before a barium swallow test.
The test takes around 60 minutes and will take place in the X-ray department of the hospital. A person will need to change into a hospital gown.
People can bring a friend or relative for support. However, the companion will not be able to join them in the X-ray room.
In the X-ray room, the person drinks the barium liquid. It often has a chalky taste but can sometimes be flavored.
In some cases, a person will be given an injection to relax their stomach.
A person will be standing for some parts of the examination, and lying down on a tilting table for other parts. This allows the liquid to travel through the body, and for the radiologist and radiographer to take a selection of images.
People do not have to stay in hospital after the test and are free to go home as soon as it is complete. The results usually arrive within 1-2 weeks.
Risks and side effects
Patients may feel nauseous after a barium swallow test or become constipated. Drinking lots of fluids can help to relieve constipation. Symptoms of nausea should improve as the barium passes through the system.
It is normal for people to have white-colored stools the first few times they use the toilet after having a barium swallow test.
Some people might worry about being exposed to radiation as part of the X-ray process. However, the amount of radiation a person is exposed to is minimal.
Sometimes, the injection given to relax the stomach can cause temporary blurred vision.
People should not have a barium swallow test if they are pregnant.
If someone has glaucoma or heart problems and needs to have a barium swallow, the doctor may not give the stomach-relaxing injection.
If someone has diabetes then the doctor will schedule a morning appointment for the barium swallow.
If the person takes tablets to control their diabetes, the doctor will tell them not to take the medicine before the test. Instead, they should bring their tablets and some food to the exam to have after it is complete.
People who use insulin will be asked to miss their morning dose and maybe the previous evening’s dose. They should bring their insulin and some food to have after the test. However, those who take long-acting insulin should continue taking this.
Another type of barium test is a barium enema. The barium enema test is similar to the barium swallow test and is used by doctors to examine the colon and rectum.
This test usually takes about 40 minutes. A person will be given a laxative the day before having a barium enema test. A laxative is a medicine that helps to clear out the bowel.
During the test, the person lies on their side on a table in the X-ray room. An enema containing barium and water is fed into their rectum through a small plastic tube. Air is also piped through the tube to inflate the bowel.
The table tilts, which spreads the barium throughout the colon. This allows the radiologist and radiographer to clearly see any lumps or swellings within the colon.
The person has to try and hold the liquid in the rectum while the test takes place. Afterwards, most of the liquid drains back into the tube and does not stay in the body.
After having a barium enema test, people may experience some cramping or diarrhea. As with the barium swallow, someone undergoing a barium enema may also have white stools the first few times they go to the toilet after the test.
There is a very small risk of the bowel lining tearing when having this test. This complication only tends to happen if the bowel is very inflamed.
Alternatives to a barium swallow test
An alternative to a barium swallow is a gastroscopy. In this procedure, a narrow, flexible, telescopic camera is used to look inside the food pipe, stomach and the first part of the small intestine.
A computed tomography (CT) scan may also be used in combination with a gastroscopy to provide X-ray images of the gut.