Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the pharynx, esophagus, stomach and first part of the small intestine (also known as the duodenum) that uses a special form of x-ray called fluoroscopy and an orally ingested contrast material called barium.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow or esophagram.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
The procedure is used to help diagnose the cause of symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices)
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
Preparation for the examination:
NPO (Nothing to eat or drink) after midnight, the morning of your exam.
How is the study performed?
This examination is usually performed on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
A radiologic technologist and a radiologist, a physician specifically trained to supervise and interpret radiology examinations, guide the patient through the upper GI series.
As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review.
The patient will be asked to hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image.
For a double-contrast upper GI series, the patient will swallow baking-soda crystals that create gas in the stomach while additional x-rays are taken.
When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
This exam is usually completed within 20 minutes.
Who will interpret the examination?
Your examination will be interpreted by a Radiologist, who is a Physician (M.D.) specifically trained to supervise and interpret radiology examinations. He/she will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you. Upon request, you can arrange a consultation with the Radiologist who interpreted your examination.