Norm of Esophageal Radiography
Normal size and normal peristalsis.
Usage of Esophageal Radiography
Achalasia, esophageal varices, esophagitis, locating a foreign body, gastrointestinal (GI) bleeding, guidance for balloon dilatation of stricture, head and neck cancer, impaction, hiatal hernia, polyps.
Description of Esophageal Radiography
A radiographic and fluoroscopic examination of the esophagus for patency, structure, and motility. When examined with the stomach, duodenum, and upper jejunum, this test is known as an upper GI series.
Professional Considerations of Esophageal Radiography
Consent form IS required.
This procedure carries minimal risks.
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 dosage 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.
- Verify that the client has fasted.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- A plain radiograph of the esophagus is taken in the supine position.
- Barium sulfate, approximately 400 mL, is then swallowed with the client in a standing position in front of the fluoroscope, and radiographs are again taken.
- Follow-up radiographs at 24 hours may be performed.
- The procedure takes 45 minutes.
- Resume diet.
- Observe for passage of barium in the stool for 2–3 days.
- A laxative may be needed to evacuate barium.
- Encourage the oral intake of fluids to help prevent barium impaction.
Client and Family Teaching
- Fast from food and fluids from midnight the day of the test.
- Drink 4–6 glasses of water per day (unless contraindicated) for 2–3 days after the test to promote barium excretion. Barium stools will look grayish white. Notify health care provider if unable to pass barium in stool within 3 days.
- Results are normally available within 24 hours.
Factors That Affect Results
- Retained barium from a previous examination interferes with the quality of the radiographic images.
- Esophageal varices are difficult to identify and are usually a sign of liver cirrhosis.
- Barium comes in flavors but is still described as unpleasant to swallow.