Barium Swallow (Esophagography)
Definition
Barium swallow, also known as esophagography, is the radiographic or fluoroscopic
examination of the pharynx and the fluoroscopic examination of the esophagus after
ingestion of thick and thin mixtures of barium sulfate.
This test, commonly performed as part of the upper GI series, is indicated for patients with a
history of dysphagia and regurgitation. Further testing is usually required for a definitive
diagnosis.
After the barium is swallowed, it pours over the base of the tongue into the pharynx. A
peristaltic wave propels it through the entire length of the esophagus in about 2 seconds.
When the peristaltic wave reaches the base of the esophagus, the cardiac sphincter opens,
allowing the barium to enter the stomach. After passage of the barium, the cardiac sphincter
closes. Normally, it evenly fills and distends the lumen of the pharynx and esophagus, and the
mucosa appears smooth and regular.
Purpose
● To diagnose hiatal hernia, diverticula, and varices.
● To detect strictures, ulcers, tumors, polyps, and motility disorders.
Procedure
Patient Preparation
1. Explain to the patient that this test evaluates the function of the pharynx and
esophagus.
2. Instruct the patient to fast after midnight before the test.
3. If the patient is an infant, delay the feeding to ensure complete digestion of the
barium.
4. Explain that the test takes approximately 30 minutes.
5. Describe the milkshake consistency and chalky taste of the barium preparation the
patient will ingest; although it’s flavored, it may be unpleasant to swallow.
Definition
Barium swallow, also known as esophagography, is the radiographic or fluoroscopic
examination of the pharynx and the fluoroscopic examination of the esophagus after
ingestion of thick and thin mixtures of barium sulfate.
This test, commonly performed as part of the upper GI series, is indicated for patients with a
history of dysphagia and regurgitation. Further testing is usually required for a definitive
diagnosis.
After the barium is swallowed, it pours over the base of the tongue into the pharynx. A
peristaltic wave propels it through the entire length of the esophagus in about 2 seconds.
When the peristaltic wave reaches the base of the esophagus, the cardiac sphincter opens,
allowing the barium to enter the stomach. After passage of the barium, the cardiac sphincter
closes. Normally, it evenly fills and distends the lumen of the pharynx and esophagus, and the
mucosa appears smooth and regular.
Purpose
● To diagnose hiatal hernia, diverticula, and varices.
● To detect strictures, ulcers, tumors, polyps, and motility disorders.
Procedure
Patient Preparation
1. Explain to the patient that this test evaluates the function of the pharynx and
esophagus.
2. Instruct the patient to fast after midnight before the test.
3. If the patient is an infant, delay the feeding to ensure complete digestion of the
barium.
4. Explain that the test takes approximately 30 minutes.
5. Describe the milkshake consistency and chalky taste of the barium preparation the
patient will ingest; although it’s flavored, it may be unpleasant to swallow.
