A barium meal, or also known as an upper gastrointestinal tract is an x-ray procedure in the purpose to take athe radiograph of the esophagus, stomach, and duodenum. In the barium meal test, an image of radiographic xray was taken of the patient's stomach and beginning of the patient's duodenum (the beginning of the small intestine, the passageway that flows food away from the stomach). The radiograph of the upper gastrointestinal tract are taken after the barium sulfate is ingested by the patient. Barium sulfate was taken orally by the patient before go through the barium meal test. Barium meal is used to diagnose the internal structural and also the abnormalities of the foregut. Barium is used because it is radiopaque, so it will show up clearly on the radiograph. The upper gastrointestinal tract also can be clearly seen on the radiographic film. In these test of barium meal,the barium was given in the form as a cup of the flavoured drink (like milkshake). Then, the barium will flows through the esophagus, and then coating the entire wall of the digestive tract and make the shape of the patient's upper gastrointestinal tract to be visible clearly on the radiograph. Without the barium, the radiograph of the upper gastrointestinal tract will be blurring or barely visible on the x-ray film.
Before going through the examination, the patient will be asked to follow the instruction given by the doctor. Patient should swallow some granules with a little water. The purpose of these procedure is to expand the stomach with gas that will make it more easier to get a clearly image of the interest. It is important way to avoid the patient from belch once they have taken these procedure. rarely, the patient also being given injection of the drugs to relax the stomach from moving during the radiograph are taken. This is to prevent the patient's vision blurring for an hour. If this happen, patient should not allowed to drive. The barium meal test will done if the patient have difficulty in swallowing or if the patient have chest pain or reflux (the condition when the stomach juices backflow into the lower part of the esophagus). Barium meal test also done when patient have pain in their abdomen , blood in their stools( may come from the duodenum, stomach, or else in their digestive tract), severe indigestion and also unexplained vomiting. This test will help the doctor to diagnose the problem of inflammation of the upper gastrointestinal wall, ulcers or tumor in the stomach or esophagus. The barium sulfate are non-toxic, so it is apart to get the risk of producing a disturbance of the bowel function for two days after the ingestion. Barium sulfate usually have a chalky taste and can adding some flavours to remove the chalky taste.A barium meal normally take less than an hour to complete. After the barium was swallowed by the patient, patient need to roll on or moving so that the barium will entirely coat the stomach and also esophagus. The radiograph will be taken after these preparation are followed.
Usually, there are two types of barium meal; there are double contrast meal and also single contrast meal. In the double contrast meal, Barium is used as well as a negative contrast medium such as carbon dioxide, air and also nitrogen. It is useful in a diagnostic test, and allowed the detection of the small mucosa lesions, for an example; Diverticula or Polyps. In single contrast meals, only barium or positive contrast medium( positive contrast media) to show the image of the upper gastrointestinal tract.
The image of barium meal
First, the patient's upper digestive tract must be empty before the test. They are advised for not to take any drink or food for a few hours before the test is done. The fasting instruction may be given to the patient by the doctor and the patient must follow the instruction. If the patient have diabetes, they must inform the doctor ask the doctor about how the preparation of the test. For the patient who is smoking, they must stop smoking and maybe asked not to smoke for a few hours before the the barium meal test. The purpose is to avoid the extra secretion flows into their digestive tract and make the blurring of the interest area on the radiograph. If the patient take any medicines ,they was asked not to take the medicine on the day of the examination, until the examination is finished. Usually,it is important to the patient for not to take antacids before the test. The indication of the barium meal test are dyspepsia, unexplained loss of weight, upper GI tract hemorrhage or iron deficiency anaemia, abdominal masses and also gastrointestinal reflux. The contraindication are, large bowel obstruction and also abdominal surgery.
Images that produced when the barium meal test are, either static radiograph image or moving radiograph images. Static image might be viewed on an x-ray film by the radiologist and are useful for detect the abnormalities of the wall in the digestive tract, for the example,tumors and ulcers. For moving images, will be viewed on a screen by the radiologist and also useful to diagnose and observe the digestive function such as fluid out flow from the stomach and also swallowing. Usually, the patient will go to the imaging department in the hospital or clinic to perform the barium meal test. Then, the patient will asked to change to their hospital gown so that folds of clothing and so that the material that might be metal on patient's cloth may not interfere with produce a clear radiographic images. In the x-ray room, the radiologist is given instruction to the patient about when and how fast to drink and swallow the barium solution. One cup of barium is swallowed by the patient. If the x-ray is taken in the stomach, the patient may asked ti drink one or two other liquid. This combination of liquid will produce a gas and will expand the patient's stomach. The patient may feel 'gassy' and the patient was asked to remains the gas in their stomach until after the procedure is done to make it easier to detect an abnormalities in its lining. It is called 'double contrast study' by the doctor.
Sometimes, patient is given injection of the muscle relaxing solution to slow the movement of the digestive tract and this will produce clearly image on the radiograph.
If patient have glycoma, they need to tell the doctor and the other as a different injection need to be used. When the patient is standing, the first x-ray will be taken. When the patient swallow the barium, the radiologist will watching on the screen moving images of the barium flows from the patient's throat, and then flows to the esophagus. X-ray will also be taken to see the barium outlines the patient's digestive tract.
The patient need to hold their breath for a few minutes while these radiograph are taken to make sure the clear image are obtained. After standing radiograph are taken, the patient need to lie down on the x-ray table and the other x-ray radiograph wil be taken. The patient need to roll on a various position so that the barium is coating the entire area of the upper digestive tract and the patient need to hold their breath again while the radiograph is taken. The barium meal test usually finished about 30minutes and the radiograph is checked wether it might be blurring or not. the 'follow through' x-ray will be required by the doctor to track the flows of the barium through the small intestine. It may take 3 or 4 hours depend on how long the fluid flows in the digestive tract.
The barium meal test is a safe test without any risks occurs. It also apply a small amount of exposure and the radiation receive by patient is low. But, the barium meal test is not suitable for the pregnant women to avoid cell mutation and effect to the fetus. Some patient might be feel dizzy, stomach upset, head ache after the barium meal. The rare of the more serious reaction are possible. If there are any reaction after the barium meal, patient need to inform their doctor immediately to prevent it become worst. The procedure of the barium meal is important to investigate the problem of the upper digestive organ.