Barium swallow
Encyclopedia
A barium swallow is a medical imaging
procedure used to examine the upper GI (gastrointestinal) tract, which includes the esophagus and, to a lesser extent, the stomach.
is a type of contrast medium
that is visible to x-rays. As the patient swallows the barium suspension, it coats the esophagus with a thin layer of the barium. This enables the hollow structure to be imaged.
This is commonly used with baking soda (sodium bicarbonate
crystals) to produce gas (see Reactions of sodium bicarbonate). As gas is low in density, and the X-rays pass through very easily, they will appear as black patches, as opposed to the white produced by relatively dense barium. As such, it is extremely useful in providing a contrast to the barium, to produce a double contrast image, to allow better visualisation of the contrasting features within the mucosal layer of the esophagus.
Barium sulfate is irritable outside the gastrointestinal tract
. In cases where a leak is suspected or desired to be demonstrated, contrast imaging involving the use of water-soluble contrast media containing iodine is used.
As with all X-rays, the barium swallow technique employs radiation
, and may irradiate the patient unnecessarily. The barium swallow should not be used unless required, and, although it cannot be replaced by endoscopy
as for the barium enema
, it should be avoided as much as possible for children and pregnant women.
. Fluoroscopy
images are taken as the barium is swallowed. This is typically at a rate of 2 or 3 frames per second. The patient is asked to swallow the barium a number of times, whilst standing in different positions, i.e. AP, oblique and lateral, to assess the 3D structure as best as possible. This technique induces gas production in the esophagus, and can be uncomfortable to the subject.
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...
procedure used to examine the upper GI (gastrointestinal) tract, which includes the esophagus and, to a lesser extent, the stomach.
Principle
Barium sulfateBarium sulfate
Barium sulfate is the inorganic compound with the chemical formula BaSO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs as the mineral barite, which is the main commercial source of barium and materials prepared from it...
is a type of contrast medium
Contrast medium
A medical contrast medium is a substance used to enhance the contrast of structures or fluids within the body in medical imaging...
that is visible to x-rays. As the patient swallows the barium suspension, it coats the esophagus with a thin layer of the barium. This enables the hollow structure to be imaged.
This is commonly used with baking soda (sodium bicarbonate
Sodium bicarbonate
Sodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula Na HCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It has a slightly salty, alkaline taste resembling that of washing soda . The natural mineral form is...
crystals) to produce gas (see Reactions of sodium bicarbonate). As gas is low in density, and the X-rays pass through very easily, they will appear as black patches, as opposed to the white produced by relatively dense barium. As such, it is extremely useful in providing a contrast to the barium, to produce a double contrast image, to allow better visualisation of the contrasting features within the mucosal layer of the esophagus.
Barium sulfate is irritable outside the gastrointestinal tract
Gastrointestinal tract
The human gastrointestinal tract refers to the stomach and intestine, and sometimes to all the structures from the mouth to the anus. ....
. In cases where a leak is suspected or desired to be demonstrated, contrast imaging involving the use of water-soluble contrast media containing iodine is used.
As with all X-rays, the barium swallow technique employs radiation
Radiation
In physics, radiation is a process in which energetic particles or energetic waves travel through a medium or space. There are two distinct types of radiation; ionizing and non-ionizing...
, and may irradiate the patient unnecessarily. The barium swallow should not be used unless required, and, although it cannot be replaced by endoscopy
Endoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...
as for the barium enema
Barium enema
A lower gastrointestinal series, also called a barium enema, is a medical procedure used to examine and diagnose problems with the human colon . X-ray pictures are taken while barium sulfate fills the colon via the rectum.-Procedure:...
, it should be avoided as much as possible for children and pregnant women.
Examination
The patient is asked to drink a suspension of barium sulfateBarium sulfate
Barium sulfate is the inorganic compound with the chemical formula BaSO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs as the mineral barite, which is the main commercial source of barium and materials prepared from it...
. Fluoroscopy
Fluoroscopy
Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. In its simplest form, a fluoroscope consists of an X-ray source and fluorescent screen between which a patient is placed...
images are taken as the barium is swallowed. This is typically at a rate of 2 or 3 frames per second. The patient is asked to swallow the barium a number of times, whilst standing in different positions, i.e. AP, oblique and lateral, to assess the 3D structure as best as possible. This technique induces gas production in the esophagus, and can be uncomfortable to the subject.
Pathology
Pathologies detected on a Barium Swallow include:- AchalasiaAchalasiaAchalasia , also known as esophageal achalasia, achalasia cardiae, cardiospasm, and esophageal aperistalsis, is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter...
- Cancer of esophagusEsophageal cancerEsophageal cancer is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer and adenocarcinoma . Squamous cell cancer arises from the cells that line the upper part of the esophagus...
- Tracheoesophageal fistulaTracheoesophageal fistulaA tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea...
- Schatzki ringSchatzki ringA Schatzki ring or Schatzki-Gary ring is a narrowing of the lower part of the esophagus that can cause difficulty swallowing. The narrowing is caused by a ring of mucosal tissue or muscular tissue. Patients with Schatzki rings can develop intermittent dysphagia , or, more seriously, a completely...
- Gastroesophageal reflux diseaseGastroesophageal reflux diseaseGastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
(GERD/GORD) - Zenker's diverticulumZenker's diverticulumIn anatomy, Zenker's diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle...
- Hiatus herniaHiatus herniaA hiatus hernia or hiatal hernia is the protrusion of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm.- Classification :There are two major kinds of hiatus hernia:...
- Obstruction of esophagus
- Esophageal stenosis
See also
- Barium enema
- Barium mealBarium mealA barium meal, also known as an upper gastrointestinal series is a procedure in which radiographs of the esophagus, stomach and duodenum are taken after barium sulfate is ingested by a patient...
- Barium follow-throughBarium follow-throughA barium follow-through procedure is a type of medical imaging technique. It is used to evaluate the presence of disease in a person's small intestine.-Examination:...