Barium Swallow: What to Expect

The 4 steps of an upper-GI series barium x-ray

A barium X-ray of the stomach.
A barium X-ray of the stomach. ZEPHYR/Getty Images

Barium x-rays are diagnostic x-rays in which barium is used to diagnose abnormalities of the digestive tract. For a barium swallow, also known as an upper-GI series, you will drink a chalky colored liquid that contains barium. It coats the walls of the esophagus and stomach, and is visible on x-rays. The person reading your x-ray can then see if there are strictures, ulcers, hiatal hernias, erosions or other abnormalities, such as tumors.

This test is not sensitive enough to be used as a reliable diagnostic test for GERD. It is used more often in patients who are experiencing difficulty with swallowing, abdominal pain, unusual bloating, and unexplained vomiting and weight loss. The barium swallow can also be used to diagnose esophageal cancer in its first stage.

There are two other types of barium x-rays: a barium edema, also called a lower-GI series, and barium small-bowel follow through. Both of which fills the intestines with barium. Both procedures are slightly different from each other as well as the barium swallow.

What can be expected if the doctor orders barium x-rays?

Your physician ordered a barium swallow, so what should you expect? It's a simple diagnostic test done on an outpatient basis at the hospital, in the radiology department. Below is a general timeline of how things will go:

  1. Do not eat or drink anything after midnight on the night before the exam.
  1. You will stand against an upright x-ray table in front of a fluoroscope, a device that will immediately show a moving picture. Then, you will drink the barium liquid and swallow baking soda crystals.
  2. The radiologist can watch the barium flow through the digestive tract. You may be asked to move into different positions while the x-rays are taken so the doctor can observe the barium from different angles as it travels down the esophagus and into the stomach.
  1. Since barium may cause constipation, drink plenty of fluids and eat high-fiber foods for the next day or two until the barium passes from the body.

Other diagnostic tests:


"Heartburn? Could It Be GERD? Understanding Heartburn and Gastroesophageal Reflux Disease (GERD)." AN417/AGA/GERD/Booklet 12/3/03. American Gastroenterological Association. 1 Feb 2007.

Costas H. Kefalas, M.D., "GI Radiographic Tests." The American College of Gastroenterology. 1 Feb 2007.

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