Norm of Barium Swallow
Requires interpretation. Characteristics examined include filling of the pharynx and esophagus, mucosal patterns, and esophageal size, contour, and peristaltic motion.
Usage of Barium Swallow
Part of the diagnostic workup for achalasia, bronchoesophageal fistula, duodenal ulcer, dysphagia, esophageal diverticula, esophageal varices, head and neck cancer, hiatal hernia, hypertrophic pyloric stenosis, pharyngeal muscle disorders, piriform sinus fistula, polyps, strictures, Plummer-Vinson syndrome, stomach cancer, tracheoesophageal compression, and ulcers.
Description of Barium Swallow
A fluoroscopic and radiographic examination of the pharynx and esophagus as mixtures of barium sulfate are swallowed. The test takes 20–30 minutes.
Professional Considerations of Barium Swallow
Consent form NOT required.
Constipation, dizziness, intestinal impaction, vasovagal reaction.
During pregnancy; clients with upper tract dysphagia; those with a risk of barium aspiration; and clients with intestinal obstruction.
During pregnancy, risks of cumulative radiation exposure to the fetus from this and other previous or future imaging studies must be weighed against the benefits of the procedure. Although formal limits for client exposure are relative to this risk-benefit comparison, the United States Nuclear Regulatory Commission requires that the cumulative dose equivalent to an embryo/ fetus from occupational exposure not exceed 0.5 rem (5 mSv). Radiation dose to the fetus is proportional to the distance of the anatomy studied from the abdomen and decreases as pregnancy progresses. For pregnant clients, consult the radiologist/ radiology department to obtain estimated fetal radiation exposure from this procedure.
- See Client and Family Teaching.
- The client is positioned on a tilt table.
- After baseline fluoroscopic examinations of the heart, lungs, and abdomen, the client takes one swallow of a thick barium mixture while cineradiographic films are taken.
- The client then takes several swallows of a thin barium mixture while its passage is recorded by fluoroscopy and radiography.
- The process is repeated with the table tilted to various positions.
- About 350–450 mL of barium is swallowed during the entire procedure.
- Where not contraindicated, the client should increase fluid intake for 24–48 hours after the test.
- Where not contraindicated, a mild cathartic may be prescribed to facilitate emptying of barium from the gastrointestinal tract.
- Failure to have a bowel movement within 2 days should be reported to the physician.
Client and Family Teaching
- Fast from food and fluids for 8 hours before the procedure.
- This procedure lasts approximately 15 minutes.
- Make sure all of the barium empties from the intestinal tract after the procedure. Drinking fluids and taking laxatives or enemas after the procedure may be prescribed for this purpose.
- See Postprocedure Care.
- Call the physician if stomach or lower abdominal pain is experienced or if stools are much smaller than the normal diameter.
Factors That Affect Results
- Barium swallow is not very sensitive as an aid in the diagnosis of proximal reflux in asthmatic children.