Upper gastrointestinal (GI) barium tests help diagnose disorders of the esophagus (tube connecting the mouth to the stomach), stomach and the first part of the small intestine known as the duodenum. Blockages, irregular growths, ulcers and other abnormalities can be revealed by these virtually painless tests, which include the barium swallow, modified barium swallow, barium meal and small-bowel series (which involves x-rays of the small intestine).

During upper GI barium tests, x-rays are taken after the patient drinks white liquid called barium. Barium is a soft metallic element. The type commonly used in medical tests is the compound barium sulfate, which is usually referred to simply as barium. It is radiopaque rather than radioactive, meaning it is not transparent to x-rays or other forms of radiation.

Once the barium has been swallowed, it coats the esophagus, stomach and duodenum. Since radiation will not pass through barium, it appears on x-rays as a light area, making barium a type of contrast medium. Recent research indicates that whole milk may be as effective a contrast medium as barium for some types of x-rays. Although milk may prove to be a more cost-effective alternative in the future, further study is needed.

Barium tests can use various imaging techniques to reveal the workings of the digestive system. Standard x-rays, fluoroscopy, cineradiography or a combination of these techniques may be used. Fluoroscopy uses a video monitor and an x-ray tube that makes an element brighter and easier to see (an image intensifier). Cineradiography (also called videofluoroscopy) uses a video camera to turn images produced by standard x-rays or fluoroscopy into a record of movement. It is used to examine the passage of food through the throat or stomach.

Conditions or situations in which an upper GI barium test may be recommended include:

• Swallowing disorders, which may have a wide range of causes (e.g., blockage, narrowing of the esophagus)
  
  
• Objects lodged in the esophagus or intestines
  
  
• Disorders of the esophagus, including narrowing or irritation, and abnormally enlarged veins that may cause bleeding
  
  
• Achalasia (condition in which the valve from the esophagus to the stomach does not relax)
  
  
• Presence of pouches (diverticula) along the esophagus
  
  
• Hiatal hernia (defect in which the stomach slides partially into the chest)
  

  

• Ulcers
  
  
• Cancerous tumors
  
  
• Polyps (growths that may be precancerous)
  

  

• Gastritis (inflammation of the stomach)
  
  
• Pyloric stenosis (narrowing in the opening of the stomach)
  
  
• Malabsorption syndrome (inadequate absorption of nutrients in the intestinal tract)
  
  
• Inflammation of the small intestines