Esophagography , also called an upper GI series, is an exam of the esophagus and stomach using barium to coat the walls of the upper digestive tract so that it can be examined with X-rays . Esophagography is used to identify any abnormalities, such as tumors , ulcers , hernias, bursae, strictures, and swallowing difficulties.
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- 1 General description of the procedure
- 2 Reasons for the procedure
- 3 Preparation for the exam
- 4 How the test is performed
- 5 Before the procedure
- 6 During the procedure
- 7 After the procedure
- 8 Normal Values
- 9 Meaning of abnormal results
- 10 Risks
- 11 Source
Esophagography is a radiographic ( x-ray ) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of the mouth and throat ) and the esophagus (a hollow, tube-like muscle that extends from under the tongue to stomach ). The pharynx and esophagus are made visible on X-ray film by a liquid suspension known as barium . Esophagography can be performed independently or as part of an upper gastrointestinal (GI) series, which examines theesophagus , stomach, and duodenum (the first part of the small intestine ).
The X – rays used rays of energy invisible electromagnetic for imaging of tissues interns, bones and organs onto film. X-rays are done using external radiation to produce images of the body , its organs, and other internal structures for diagnostic purposes. The X-rays pass through the body’s tissues onto specially treated plates (similar to photographic film) and a “negative” type photo is taken (the more solid the structure, the whiter it appears on the film).
Fluoroscopy is usually used during an esophagography . It is a study of the structures of the body in motion, similar to an X-ray “film”. A continuous beam of X-rays is passed through the part of the body being examined and transmitted to a TV- like monitor so that the part of the body and its movement can be seen in detail . In barium x – ray procedures , fluoroscopy allows the radiologist to view the movement of the barium through the pharynx and esophagus as the patient drinks it.
Reasons for the procedure
Esophagography may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus . These abnormalities may include, but are not limited to, the following:
- cancer of the head , neck , pharynx, and esophagus .
- hiatal hernia – upward movement of the stomach , either within or along the esophagus
- structural problems, such as diverticula, narrowing, or polyps (growths)
- varicose veins (enlarged veins) of the esophagus
- muscle disorders (of the pharynx or esophagus ) such as dysphagia (difficulty swallowing) or spasms (of the pharynx or esophagus )
- achalasia : the lower esophageal sphincter does not relax and prevents food from passing into the stomach
- disease of the gastroesophageal reflux disease (GERD, for its acronym in English) and ulcers
Your doctor may also recommend a swallow scan for other reasons.
Preparation for the exam
Your diet may need to be changed for 2 to 3 days before the test, and you are usually unable to eat for a period before the procedure.
You should ask your doctor if there are any restrictions regarding [drug] s. You can often continue taking oral medications . Never make any changes to your medications without first checking with your doctor.
In addition, you will be asked to remove all jewelry on your neck , chest, or abdomen before the exam.
How the test is performed
Typically, a swallow scan can be done on an outpatient basis, performed in a doctor’s office, or in the radiology room of a hospital .
Patients may be advised to refrain from eating or drinking after midnight the night before the exam.
Although each hospital may have specific protocols, normally the procedure of an esophagography follows this process:
- The patient will be asked to drink the barium liquid and swallow crystals of bicarbonate . It is important not to burp, as the gas assists the radiologist in the evaluation.
- The patient will stand behind a machine called a fluoroscope (a device to immediately display an X-ray image ).
- The patient may be asked to stand in different positions and hold their breath while the x-rays are taken .
- If the small intestine is to be examined , the patient may be asked to drink more barium liquid and a series of x – rays will be taken until the barium reaches the colon .
- After the test, the barium can cause constipation . The patient may be advised to drink plenty of fluids and eat high fiber foods to flush the barium out of the body .
Before the procedure
- Your doctor will explain the procedure to you and offer you the opportunity to ask any questions you may have about it.
- You may be asked to sign a consent form authorizing the procedure. Read the form carefully, and ask if there is anything that is not clear to you.
- You will be asked to fast for eight hours before the procedure, usually after midnight.
- If you are pregnant or suspect that you are pregnant, you should tell your doctor.
- Inform your doctor if you have any sensitivity or allergy to any medications , latex , tape , and anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal supplements that you are taking. Your doctor may advise you to stop some medications before the procedure.
- Inform the radiologist if you have recently had a barium X-ray study or cholangiogram, as this may interfere with obtaining optimal X-ray exposure of the upper GI area.
- Depending on your clinical status, the doctor may request other specific preparation.
During the procedure
Generally, esophagography follows this process:
- You will be asked to remove clothing, jewelry, or other objects that may interfere with the procedure.
- If you are instructed to remove your clothes, you will be given a gown to put on.
- You will be placed on an X-ray table that can move you from a horizontal to a vertical position. You may also be instructed to change positions (for example, lie on your side, on your back, or on your stomach ) at intervals during the procedure.
- Standard x-rays of the heart , lungs, and abdomen may be done earlier.
- The radiologist will ask you to drink a thick drink that contains barium . Barium is generally flavored, although it may not be very palatable.
- While you are taking the barium , the radiologist will take individual pictures, a series of X – rays, or a video ( fluoroscopy ) to observe the movement of the barium through the pharynx .
- At certain times during the procedure, you may be asked to hold your breath.
- You will be given a barium solvent drink to drink . They are used X – ray or fluoroscopy to observe the passage of the barium by the esophagus . You may also need to swallow a barium “marshmallow,” which is a small piece of bread soaked in barium that helps to visualize certain structural problems in the esophagus .
- If an additional procedure called a ” small bowel contrast study ” was ordered , it will be done after the esophagogram is finished.
- Once all required x-rays have been taken , you will be assisted off the table.
After the procedure
You can resume your diet and normal activities after your esophagogram, unless your doctor tells you otherwise. The barium can cause constipation or possible retention after the procedure if it is not completely eliminated from the body . You may be advised to drink plenty of fluids and eat high fiber foods to flush the barium out of the body . You may also be given a purgative or laxative to help remove the barium .
The barium is not absorbed in the body but passes through the gastrointestinal tract; Because of this, your bowel movements may be lighter in color until all of the barium is expelled .
Notify the doctor of any of the following:
- difficulty or inability to defecate
- abdominal pain and / or bloating
- stools that are smaller than normal diameter
Your doctor may provide additional or alternative instructions after the procedure, depending on your specific situation.
Esophagography showing no oral contrast leakage.
A normal result shows that the esophagus , stomach, and small intestine are normal in size, shape, and movement.
The ranges of normal values may vary depending on the laboratory performing the test. Talk to your doctor about the meaning of your specific test results.
Meaning of abnormal results
In the esophagus , abnormal results can mean:
- esophageal cancer
- benign esophageal stricture (narrowing)
- hiatal hernia
In the stomach , abnormal results can mean:
- gastric cancer
- benign gastric ulcer
- polyps (a usually non-cancerous tumor that develops on the mucous membrane)
- pyloric stenosis (narrowing)
In the small intestine , the exam may reveal:
- malabsorption syndrome
- inflammation and irritation of the small intestine
Other conditions under which the test may be performed:
- Annular pancreas
- Duodenal ulcer
- Disease of gastroesophageal reflux
- Intestinal occlusion
- Lower esophageal ring
- Primary or idiopathic intestinal pseudo-obstruction
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your radiation exposure history , such as previous scans and other types of radiological scans, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and / or treatments over an extended period of time.
If you are pregnant or suspect that you are pregnant, you should tell your doctor. Exposure to radiation during pregnancy can cause birth defects.
Patients with allergies or sensitivities to medications, contrast dyes, iodine , shellfish , or latex should notify their physician.
Constipation or impaired stool can occur if the barium is not completely removed from the body .
Some contraindications to esophagography may include, but are not limited to:
- perforation of the esophagus or intestinal perforation
- bowel obstruction or severe constipation
- severe swallowing difficulties leading to the possibility of aspiration (entry of substances into the lungs) of barium
There may be other risks depending on your specific health condition . Remember to consult all your doubts with your doctor before the procedure.
Certain factors or conditions can interfere with the accuracy of the esophagogram. An X – ray of barium or recent cholangiography can interfere with the exposure of the upper GI area to X – rays