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Upper GI Series

Digestive System

The upper gastrointestinal (GI) series uses x-rays to diagnose problems in the esophagus, stomach, and duodenum (first part of the small intestine). It may also be used to examine the small intestine. The upper GI series can show a blockage, abnormal growth, ulcer, or a problem with the way an organ is working.

During the procedure, you will drink barium, a thick, white, milkshake-like liquid. Barium coats the inside lining of the esophagus, stomach, and duodenum and makes them show up more clearly on x-rays. The radiologist can also see ulcers, scar tissue, abnormal growths, hernias, or areas where something is blocking the normal path of food through the digestive system. Using a machine called a fluoroscope, the radiologist is also able to watch your digestive system work as the barium moves through it. This part of the procedure shows any problems in how the digestive system functions, for example, whether the muscles that control swallowing are working properly. As the barium moves into the small intestine, the radiologist can take x-rays of it as well.

The procedure is often enhanced by making the patient consume additional material, often referred to as "sparkles" or "fizzies."  These materials cause gas to be released inside the upper digestive tract, forming air to act as an additional contrast agent.  The "double-contrast" upper gastrointestinal series is considered to be more accurate than single contrast studies in many situations. Many people cannot tolerate the extra gas, so the technique is not used in all situations.  An even more sensitive variation on the small bowel portion of the test is known as enteroclysis. Contrast that usually consists of barium and a special cellulose material is flushed directly into the bowel under pressure through a small tube placed through the nose into the bowel under X-ray guidance.  This technique allows smaller abnormalities to be seen in the small intestine.  This highly specialized and rarely used test is sometimes used when there is a question about GI blood loss that is not answered using the more conventional tests.

An upper GI series takes 1 to 2 hours. It is not uncomfortable. The barium may cause constipation and white-colored stool for a few days after the procedure. In preparation for this testing, your stomach and small intestine must be empty for the procedure to be accurate, so the night before you will not be able to eat or drink anything after midnight. Your physician may give you other specific instructions.

The upper GI/small bowel series test is sometimes used in place of other more invasive tests in patients who may have trouble tolerating such examinations as endoscopy.  Advances in endoscopy equipment over the last few years have made the upper GI series less used than it used to be.  Certain conditions still call for the upper GI/small bowel series, however. Ask your doctor or your healthcare provider and follow their advice about testing recommended in your particular case.

(Partially adapted from NIH)