What is a barium swallow?
A barium swallow is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (a hollow tube of muscle extending from below the tongue to the stomach). The pharynx and esophagus are made visible on X-ray film by a liquid suspension called barium sulfate (barium). Barium highlights certain areas in the body to create a clearer picture. A barium swallow may be performed separately or as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and duodenum (first part of the small intestine).
X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film. X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body tissues onto specially-treated plates (similar to camera film) and a "negative" type picture is made.
Fluoroscopy is often used during a barium swallow. Fluoroscopy is a study of moving body structures—similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. In barium X-rays, fluoroscopy allows the radiologist to see the movement of the barium through the pharynx and esophagus as a person drinks.
Why is barium used with X-rays?
Barium is a dry, white, chalky, metallic powder that is mixed with water to make a thick, milkshake-like drink. Barium is an X-ray absorber and appears white on X-ray film. When swallowed, a barium drink coats the inside walls of the pharynx and esophagus so that the swallowing motion, inside wall lining, and size and shape of these organs is visible on X-ray. This process shows differences that might not be seen on standard X-rays. Barium is used only for diagnostic studies of the GI tract.
The use of barium with X-rays contributes to the visibility of various characteristics of the pharynx and esophagus. Some abnormalities of the pharynx and/or esophagus that may be detected by a barium swallow include tumors, ulcers, hernias, diverticula (pouches), strictures (narrowing), inflammation, and swallowing difficulties.
Another related procedure that may be used to diagnose upper GI problems is esophagogastroduodenoscopy (EGD). Please see this procedure for additional information.
About the pharynx and esophagus
Digestion is the process by which food and liquid are broken down into smaller parts so that the body can use them to build and nourish cells, and to provide energy. Digestion begins in the mouth, where food and liquids are taken in, and is completed in the large intestine.
One of the main functions of the pharynx is swallowing. The main function of the esophagus is the forward propulsion of foods to the stomach.
Reasons for the procedure
A barium swallow may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus. These abnormalities may include, but are not limited to:
Cancers of the head, neck, pharynx, and esophagus
Hiatal hernia. Upward movement of the stomach, either into or alongside the esophagus
Structural problems. Such as diverticula, strictures, or polyps (growths)
Esophageal varices (enlarged veins)
Muscle disorders(pharyngeal or esophageal). Such as dysphagia (difficulty swallowing) or spasms (pharyngeal or esophageal)
Achalasia. A condition in which the lower esophageal sphincter muscle doesn't relax and allow food to pass into the stomach
Gastroesophageal reflux disease (GERD) and ulcers
There may be other reasons for your physician to recommend a barium swallow.
Risks of the procedure
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation. It's a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your physician. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.