Upper GI Series (Barium Swallow)

Author: Courtney Misher, MPH, BS R.T.(T)
Last Reviewed: August 08, 2022

An upper GI series, also called a barium swallow, uses x-rays to help find problems in the upper gastrointestinal (GI) tract. An upper GI series is done by a radiology technologist or a radiologist, a doctor who specializes in x-ray imaging, at a hospital or outpatient center. The esophagus, stomach, and duodenum are the parts of the upper GI system. The duodenum is the first part of the small intestine.

Why would I need an upper GI series?

An upper GI series can be used to find the cause of:

  • Abdominal (belly) pain.
  • Nausea.
  • Vomiting.
  • Trouble swallowing.
  • Heartburn.
  • Unexplained weight loss.

How do I prepare for an upper GI series?

To prepare for an upper GI series you will likely be asked not to eat, drink, smoke, or chew gum for 8-12 hours before the test. You may need to eat a low-fiber diet for 1-3 days before the test and you may need to take a laxative. Having an empty GI tract is important to see your GI tract clearly.

Tell your doctor about medications you are taking and any health conditions you have including allergies to medications or foods. You may be asked not to take certain medications before the test. You should let your doctor know if you are or may be pregnant. Your doctor may suggest a different test or use special precautions to reduce exposure to the fetus.

How is the test performed?

During the test you will either be sitting or standing in front of an x-ray machine to have images taken. You will drink a white, chalky liquid contrast called barium. The barium coats the lining of the upper GI tract showing signs of disease more clearly on the x-rays.

You will then lie down, and more x-rays are taken. You may be asked to hold still in many positions. This allows the technologist or radiologist to take x-rays of the upper GI tract at different angles. They may also watch the barium move through your GI tract using fluoroscopy. Fluoroscopy uses x-rays to see real-time moving images of your internal organs.

Sometimes, a technique called a ‘double contrast study’ is used. The double contrast study uses air and barium for a clearer view of the stomach lining. For this study, you swallow gas-forming crystals that will mix with the barium to form gas. The gas expands your stomach allowing for more detailed x-rays images to be taken.

What to expect after an upper GI series?

Often, you can go back to your normal diet and activities right away. You may have bloating and nausea for 1-3 days after your test. The barium will cause your stool (poop) to be white or light colored. Mild constipation from the barium is a common side effect. To avoid this, drink plenty of fluids after the exam.

How do you receive the results of your upper GI series?

A radiologist reviews the x-rays and writes a report for your provider. Your provider will talk to you about your results. Depending on what the test shows, you may need more tests.

When should you contact your care team?

In rare cases, barium can block the intestines. This can be a life-threatening condition. Symptoms of this are:

  • Severe pain in your abdomen.
  • Not having a bowel movement 2-3 days after the test.
  • Not able to pass gas.
  • Fever.
  • Bleeding from the rectum.

Barium can also cause an allergic reaction. Signs of an allergic reaction include hives, itching, trouble breathing, agitation, or confusion.

Contact your care team if you develop any of these rare side effects. If you are unable to contact your care team, call 911, or visit an emergency room.

U.S. Department of Health and Human Services. (n.d.). Upper GI series. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved August 5, 2022, from https://www.niddk.nih.gov/health-information/diagnostic-tests/upper-gi-series

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