X-ray of the upper digestive tract

Publication date: 26.08.2019

Description of the examination

To make upper digestive tract (i.e. oesophagus, stomach, duodenum) visible, contrast medium (bar sulphate) is administered orally, which absorbs X-rays. This preparation is absorbed in mucous membrane folds of digestive tract. While turning the patient around in laying or standing position (depending on radiological examination phase) whole ventricular mucosa coats with a contrast what enables choosing of best projection. Next, after passing of the Roentgen beam through the patient’s body, photo documentation is performed. Obtained image is a “casting” of a digestive tract filled with contrast. Examinations of oesophagus, stomach and duodenum are performed simultaneously. Very often, apart from performing of Roentgen images, radioscopy is performed. Due to employed equipment it is possible to change radiological image into a visual signal (thus the name radioscopy), which is registered on a monitor. It enables assessment of changes of radiological image of examined digestive tract structures in time. The examination begins with administration of about 50 ml of barium meal to the patient. Next, while turning the patient along long axis of the body, the radiologist performs imaging documentation, with a help of radioscopy during several examination phases. The patient is standing or lying down. At some stage the radiologist applies dosing pressure to some abdominal areas to obtain adequate amount of contrast agent on mucous surface and to expose several fragments of digestive tract. The result of the examination is given to the patient as a description, sometime with X-ray images.

What does the examination show?

The examination helps to detect changes of intestines silhouette (contrast surplus or loss) and stiffness of intestine wall. During the examination radioscopy may be used – not only to choose the best projection, but also for diagnostics of functional digestive tract abnormalities. Stomach examination may be single-contrasted (while small amount of contrast agent is ingested to show mucus folds) and double-contrasted (when apart from contrast agent, an air is administered into the stomach; this examination allows assessment of mucous surface details and it’s smallest elements – gastric areas, and stomach lumen and silhouette are assessed subsequently. Those methods can’t be employed concomitantly, as both require different barium density. Double-contrast stomach examination effectively detects stomach ulcers (with effectiveness similar to endoscopy). However it should be emphasized that radiological examinations won’t detect flat mucous lesions that are visible during endoscopy, radiological image may be ambiguous and there is no possibility of histopathological diagnosis. Radiological examinations however can be better than endoscopy assesses oesophageal and further parts of digestive tract function. Usually hiatal hernia can be easier diagnosed with radiological examination than with endoscopy. Upper digestive tract contrast examination can be performed farther, and filling of small intestine and then large intestine with contrast agent may be observed. This examination is called GI series. Indications for the examination Clinical symptoms of upper gastrointestinal tract abnormality in case there is no possibility of performance of endoscopic examination or there exist contraindications to it. Diagnostic doubts during endoscopic upper GI examination or when radiological examination is a complement to endoscopic examination, for example in case of hiatal hernia suspicion or during assessment of peristaltic waves (movement of GI tract walls).
The examination is performed on doctor’s orders.

Preparation for the examination

It is not necessary to do other examinations before. The day before the examination, the patient cannot eat supper, the patient comes for the examination before they have eaten. If the examination is performed in the afternoon, the patient can eat a light supper and cannot eat on the day of the examination. The patient should not smoke on the day of examination. The examination lasts several minutes.

What you should tell the examiner

Before the examination:

  • any medicines taken on the day of examination
  • pregnancy

During the examination:

  • any sudden complaints (e.g. pain)

What to do after the examination?

There are no special recommendations.

Possible complications after the examination

No complications. If necessary, the examination can be repeated periodically. It can be performed on patients of all ages. It cannot be performed on pregnant women. It should be avoided in women in the 2nd half of the menstrual cycle.