An esophagram is an X-ray test of your esophagus. The esophagus is a tube like passageway from your throat to the stomach. The test looks at your esophagus while you swallow a white chalky substance called barium using X-ray imaging.
Reasons to get barium esophagram procedure
Barium esophagram or barium swallow is often ordered by your doctor to investigate why you may be having symptoms related to your upper gastrointestinal tract. These symptoms may include difficulty swallowing, food getting stuck in your chest, indigestion, reflux and others.
Where is an esophagram done?
The test is usually done in the radiology department. Both a radiologist and a technologist are usually present during the exam.
How is a barium esophagram performed?
You will be asked to take swallows of barium which is a white chalky substance. The barium allows the lining of the esophagus to be seen on x ray. In many cases, you will also be asked to swallow a fizzy mixture which produces gas and allows the radiologist to see more detail. While not tasting great, barium is tolerated fairly well by patients. The fizzy crystals will make you want to burp, but it’s important that you don’t as the gas buildup allows the radiologist to see more detail.
During the actual exam, the radiologist will instruct you to swallow the barium and will take X-rays in standing and lying positions. You may be asked to swallow a barium pill to see how it goes down. The technologist will assist the radiologist in positioning the patient and making sure the exam goes smoothly.
Fluoroscopy in esophagram
A barium esophagram is done using fluoroscopy. This is a continuous X-ray which allows us to observe the esophagus while your swallowing.
Do they put you to sleep for an esophagram?
No. You are awake during the procedure. The test requires your cooperation.
Can I drive home after an esophagram?
Yes. Barium swallows use no medicines or sedation which would cause any issues with you driving.
Esophagram vs barium swallow
This is simply two different names for the same test.
How long does a barium esophagram take?
The test itself takes under half an hour. You may be at the facility longer however when you include check in and preparation.
What are the risks of a barium esophagram?
This is a safe procedure and I rarely see problems. It is possible that the barium you swallow may go into your lungs. In most cases this is benign as barium does not usually cause problems in the lungs.
The radiation exposure you get is fairly small and should not pose a big risk.
Barium spillage into your abdomen is a concern as it can cause inflammation. This is only a concern if your bowel is perforated. Usually we know this in advance.
If your bowel is obstructed, this can cause things to get worse.
Perhaps the most common risk is constipation which can be lessened by drinking Plenty of fluids. You can also have white or lighter then usual stools.
What should I expect after a barium swallow?
Usually, you can resume normal activities. After the test, the radiologist will provide a detailed report of findings to your doctor.
What can a barium esophagram diagnose?
Common findings found are areas of narrowing or strictures. We often see hernias of your stomach. Motility problems such as how your esophagus pushes food through to the stomach. We can see reflux of stomach contents. We can see cancers and masses.
Will I need more testing after an esophagram?
Endoscopy is a test performed by a gastroenterologist to examine the upper gastrointestinal tract. He inserts a flexible tube into your throat with a camera attached and visually inspects the upper GI tract.
In my practice, many patients who have an esophagram have already had endoscopy or are scheduled. It is complementary information.
The esophagram is not as good as endoscopy at detecting abnormalities of the lining of the esophagus, the most important being cancer.
Barium esophagram procedure: summary
A barium esophagram is done to examine the structure and function of the esophagus. We can diagnose narrowing, inflammation, reflux and cancer. The test is not as good as endoscopy at examining the lining of the esophagus. An esophagram is a fairly quick, easy and inexpensive way to examine the esophagus.