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BARIUM SWALLOW

WHAT IS IT?

Abstract

VOL: 99, ISSUE: 37, PAGE NO: 27

 

WHAT IS IT?
- Barium swallow is an X-ray procedure which is used to examine the oesophagus.

 

 

- The procedure has been shown to give good detail of the mucosa and is also useful for showing changes in oesophageal motility.

 

 

- It takes about 10-20 minutes to perform.

 

 

- It is usually carried out in the X-ray department by a radiologist and radiographer.

 

 

- The patient swallows a solution of barium sulphate, which provides a contrast to enhance X-ray images.

 

 

WHY IS IT PERFORMED?
- As a diagnostic tool for patients with symptoms such as dysphagia (difficulty swallowing), heartburn and regurgitation.

 

 

- As videofluoroscopy in order to monitor patients with long-term swallowing difficulties.

 

 

CONTRAINDICATIONS
- None.

 

 

PATIENT PREPARATION
- The radiologist should be supplied with the patient history.

 

 

- A full explanation of the procedure should be given to the patient.

 

 

- If views of the stomach are required, patient is nil by mouth for 4-6 hours prior to the procedure.

 

 

- Some outpatient centres request the patient not to smoke for three hours prior to the procedure.

 

 

THE PROCEDURE
- Patient lies prone on an X-ray table.

 

 

- A mouthful of barium is given through a straw.

 

 

- Patient is asked to swallow and images are taken as barium passes through oropharynx into oesophagus.

 

 

- Radiologist views the passage of barium until it enters the stomach.

 

 

- As the barium passes the lower oesophageal sphincter the radiologist asks the patient to take a deep breath to assess the effect of diaphragmatic movement.

 

 

- Several swallows may be used.

 

 

- For patients with problems swallowing solids the barium may be mixed with food, such as biscuits.

 

 

- When sufficient images have been obtained the patient can sit up.

 

 

SAFETY CONSIDERATIONS
During the procedure:

 

 

- Observe patient’s tolerance of the procedure, for example pain;

 

 

- Provide reassurance, commentary and support;

 

 

- Watch out for any unexpected events, such as vomiting, cardiorespiratory depression, or vasovagal reactions;

 

 

- Ensure resuscitation equipment is to hand.

 

 

- Note: each barium study exposes patients and staff to radioactivity. The longer the study, the greater this exposure will be. As a result, all staff take precautions to prevent exposure and the radiographer will document the amount of exposure each patient receives.

 

 

AFTERCARE
- Assess and document patient’s status on completing the procedure.

 

 

- Document all care given and any unusual events that occur.

 

 

- Provide written instructions regarding diet, medications, activity restrictions, follow-up and possible complications.

 

 

- The patient’s stools may be lighter in colour for a few days due to the ingestion of barium.

 

 

POTENTIAL RESULTS
- Normal swallow with good coordination and peristalsis. Normal oesophageal mucosa.

 

 

- Oesophageal: webs; neoplasms; dysmotility; achalasia; diverticula; gastro-oesophageal reflux disease and oesophagitis; poor swallowing coordination.

 

 

POTENTIAL COMPLICATIONS
- Major complication: aspiration.

 

 

- Minor complications: constipation, nausea and belching.

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