Barium Swallow

What is a Barium Swallow?

Barium swallow is a type of upper GI series; the endoscopy x-ray happens the same way, but is limited to the pharynx and esophagus. Barium swallow is not designed to detect issues with a patient’s stomach and small intestine. The procedure involves drinking a barium contrast solution and using a special kind of x-ray referred to as fluoroscopy is used to capture moving images of the patient’s upper GI tract.

During the procedure, patients will need to ingest a thick, white and chalky barium solution. The barium solution coats the lining of the patients’ throats, and will allow the shape and movement of the organ to be seen on a video monitor. Patients will also be asked to swallow special crystal substances containing baking soda, which will react with the barium solution and produce a gas that will inflate the GI tract for better viewing. If this second step is taken, you are undergoing what is called a double-contrast test.

Why Should I Get a Barium Swallow?

Many digestive disorders can be diagnosed and treated with a barium swallow or an upper GI series. Barium swallows can also show tumors or polyps that have emerged from the esophageal wall and prompt doctors to order further tests or procedures such as biopsy or polyp removal. Barium swallow, these days, is mostly used for evaluation of esophageal dysmotility or difficulty swallowing. Other conditions that may be found during barium swallow include inflammation, hiatal hernias, blockages, scars and other abnormalities.

How Do I Prepare for and Follow Up with Barium Swallow?

As with most endoscopy procedures of this sort, barium swallows require that patients stop eating food and taking medication for several hours before the x-rays are taken. Having the stomach completely empty will ensure that clearer images are produced from the test. Even chewing gum may result in residual content in the esophagus that may be accidently mistaken for a medical irregularity.

Patients will need to remove clothing and wear a hospital gown, because the presence of metal (i.e. on buttons or zippers) will distort the final x-ray image; jewelry and many dental pieces must also be removed. Pregnant women and patients with artificial body parts installed may be unable to undergo the procedure safely and may need to discuss with their doctors an alternate test. Also discuss with your specialist before proceding with a barium swallow, as this test can interfere with some endoscopic examinations and shouldn’t be done without a consultation.

After the test, you’ll need to try and rid your body of the barium contrast material before it has a chance to harden in your bowels and cause obstruction. This is generally achieved by drinking more fluids than usually and encouraging your body to pass stool. Don’t be alarmed if your stool looks pink or white in color for a few days, as it probably is just coating in barium. If you have questions about barium swallow, please contact a gastroenterology professional listed in our directory.


Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014