Barium swallow / meal / follow through

This leaflet tells you about the procedures (barium swallow / meal / follow through) that look at your oesophagus (gullet or throat), stomach, and small intestine. It explains what is involved and the possible risks. It is not meant to replace discussion between you and your doctor but can act as a starting point for such a discussion. Please feel free to discuss the examination with your referring doctor (GP or specialist) or the person carrying out your examination.

What is a barium swallow / meal / follow through?

The stomach and other parts of the gut do not show up well on ordinary x-rays, so it is necessary to outline them better. This is achieved by coating them with barium (a heavy white fluid) and occasionally filling the stomach with air.

Why do I need a barium swallow / meal / follow through?

Barium examinations are one of the easiest ways of imaging the upper part of the digestive tract. You may have a variety of symptoms including difficulty in swallowing, pain, and weight loss, and your doctor has decided to investigate the cause.

Who has requested this procedure?

The doctors in charge of your case, after discussion with you, feel that this may help with your diagnosis.

Who will be doing the barium swallow / meal / follow through?

A radiologist or specialist radiographer (clinician) will carry out your examination. They will be assisted by either a radiographer, assistant / student radiographer, or nurse. The clinician will then review the images and issue a report to your referring doctor.

Where will the procedure take place?

The procedure will take place in a ‘screening room’ within the X-ray Department.

Please note that due to the nature of the examination we are unable to accommodate unaccompanied children within the department.

How do I prepare for a barium swallow / meal / follow through?

For your examination to be successful, your stomach and small intestine need to be empty. Therefore you will be asked not to eat or drink for several hours before your examination (usually from 10pm the night before); full instructions will be included with your appointment letter.

If you are diabetic and have concerns about fasting, please contact your GP or diabetic nurse.

What happens during a barium swallow / meal / follow through?

The clinician leading the investigation will introduce themselves and explain the procedure. You will be positioned in front of the screening machine, standing on a small step attached to the couch in its upright position. You will be given a cup of barium to drink, whilst x-ray images are taken so we can see your oesophagus.

If images of your stomach are needed you may be given a small injection into a vein in your arm. You may also be given some granules and lemon juice to drink; this fills your stomach with gas to allow the clinician to get better images.

If images of your small bowel are needed you will be asked to wait in the waiting room while images are taken at intervals.

Will it be uncomfortable?

If you have an injection, you will feel some minor discomfort. You might feel slight discomfort from your stomach being full of air.

How long will it take?

It should take about 10 to 20 minutes to image your oesophagus or stomach. We recommend that you allow at least one hour for the examination.

If images of your small bowel are needed you could be in the department for two or three hours.

Are there any risks or complications?

All x-ray procedures involve exposure to radiation in varying amounts. The duration and level of x-rays are kept to a minimum, but you need to be exposed to x-rays for two to three minutes. This is the same as what we receive naturally from the environment over a period of 12 to 18 months.

There is also a small risk from the injection. Please tell the radiographer if you have heart disease, glaucoma, or myastheania gravis.

Despite these risks, your doctor will have come to the conclusion that they recommend you should have this examination. Remember that the risks from missing a serious disorder by not having the examination, are considered to be much greater.

For patients of childbearing age

If there is any possibility you are pregnant, please contact the department for advice.

What if I have any further questions?

Hopefully this leaflet will answer a lot of your questions, but remember that you may ask the doctors looking after you about any of your tests or treatment. Or you can contact Radiology and speak to a barium radiographer or radiology nurse on telephone 01233 616033.

References

This leaflet is produced with grateful acknowledgment to the Patient’s Liaison Group of the Royal College of Radiologists and East Kent Radiology Staff.