Upper GI Series

What is an Upper GI Series?

An upper GI Series is an endoscopy procedure that focuses on the body’s upper gastrointestinal tract, or GI tract. The human GI tract consists of many parts, starting from the mouth and ending at the anus—but the upper GI tract is considered to be a person’s esophagus, stomach and duodenum (the part of the small intestine located highest up the GI tract).

If a patient’s upper GI tract is affected by ulcers, scars, hernias, diverticula (pouches along the walls of the esophagus and intestines) or other obstructions, an upper GI series will be likely to detect these problems without having to resort to invasive surgery or other uncomfortable procedures. As with any medical screening, however, there is a chance that smaller abnormalities may be overlooked during the imaging procedure. The clarity and detail that can be achieved with x-ray is limited and, unfortunately, is usually not the method preferred by most endoscopists (doctors or technicians who look inside a patient’s body in order to diagnose).

What Happens During an Upper GI Series Procedure?

X-rays are taken at a radiology center or a doctor’s office with access to the proper equipment. The patient will stand in front of a special machine and drink a barium solution, a semi-thick liquid designed to make the lining of the upper GI tract show up as a bright, white color on the final image. A technology called fluoroscopy (an x-ray video) allows for viewing of the liquid as it moves downward and coats the patient’s throat, stomach and intestines. If the patient moves around—which he or she may be asked to do—the liquid will visibly move around on the x-ray monitor.

If a doctor has ordered a double contrast study, the patient may have to ingest special crystals designed to inflate the upper GI tract before more x-rays are performed. The crystals react with the barium solution around inside the patient’s body to produce gas that expands the area for a clearer view.

Should I Order an Upper GI Series?

Upper GI series are usually ordered in response to patients’ complaints of dysphagia (difficulty swallowing), nausea or vomiting that persists for more than 2 weeks. The idea is that growths or other abnormalities in the throat, stomach and small intestine can keep a person’s digestive system from processing food easily, either by blocking the food content’s path through the GI tract or making food digestion a painful task. For example, an ulcer (an open sore on the inside of the body) located in the esophagus may be irritated whenever a person eats, which may cause uncomfortable symptoms and worsen if the ulcer is left unattended. Patients who suffer from gastroesophageal reflux disease (also known as GERD or acid reflux disease) often undergo upper GI series, as well, so doctors can check for underlying medical causes.

What Should I Do Before and After an Upper GI Series?

Before an effective upper GI series can be performed, the patient must completely empty his or her upper GI tract. Food particles and any other content left inside the tract might show up on the final x-ray scan and look like a polyp or ulcer, or simply cause the shape of the throat, stomach and large intestine to be inaccurately reflected. Emptying the tract is generally done by fasting for 8 to 12 hours before the procedure. During this time, patients should also refrain from smoking and chewing gum or mints. Luckily, preparing a patient’s upper GI tract for an upper GI series or a barium swallow is much easier than preparing the lower GI tract (primarily the colon) for a colonoscopy, a barium enema or other colon screening—most patients do not complain of discomfort or too much inconvenience.

Before an upper GI series procedure, please also let your doctor know if you are pregnant, if you have special good allergies or if you are taking any medications. Particularly for pregnant women, alternate tests such as upper endoscopy may be preferred instead to limit radiation exposure.

After the upper GI series, you will leave the medical facility probably feeling a little bloating or nauseous. Your stools may also appear white or pink, but this is completely normal because your body is trying to get rid of the barium solution. Try and drink plenty of liquids after the procedure so all the barium will be flushed out before it has a chance to harden inside the body. If you notice any severe symptoms, such as constipation, fever, or sharp pains—please contact your doctor immediately for a follow-up exam, as these symptoms are not normal.


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