Barium Swallow

January 16, 2018

A barium swallow is an imaging test that uses X-rays to look at your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.

You may have just a barium swallow. Or this test may be done as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).

X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to find bone or joint problems, or to check the heart and lungs. A barium swallow is one type of X-ray.

Fluoroscopy is often used during a barium swallow. Fluoroscopy is a kind of X-ray “movie.”

The test also uses barium. Barium is a substance that makes certain area of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

A barium swallow may be done to look for and diagnose problems in the pharynx and esophagus. You may need a barium swallow if your healthcare provider think that you have:

  • Cancer of the head, neck, pharynx, or esophagus
  • Hiatal hernia. This means that your stomach has moved up into or alongside the esophagus.
  • Structural problems, such as pouches (diverticula), narrowing (strictures), or growths (polyps)
  • Enlarged veins (esophageal varices)
  • Muscle disorders, such as difficulty swallowing (dysphagia) or spasms
  • Achalasia. This is a condition in which the lower esophageal sphincter muscle doesn't relax and allow food to pass into the stomach.
  • Gastroesophageal reflux disease (GERD) and ulcers

Your healthcare provider may have other reasons to recommend a barium swallow.

You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you.

Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.

Tell your provider if:

  • You are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects.
  • You are allergic to or sensitive to medicines, contrast dyes, local anesthesia, iodine, or latex

You may have constipation or impacted stool after the test if all of the barium does not pass out of your body.

You should not have a barium swallow if you have:

  • A tear or hole in your esophagus or intestines (perforation)
  • Blockage in your intestines or severe constipation
  • Severe problems with swallowing. This makes it more likely that barium would accidentally go into your lungs (aspiration).

You should also not have this test if you are pregnant.

You may have other risks depending on your specific health condition. Be sure to talk with your provider about any concerns you have before the procedure.

  • Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
  • You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
  • You will need to stop eating and drinking for about 8 hours before the test. Generally, this means after midnight.
  • Tell your provider if you are pregnant or think you may be pregnant.
  • Tell your provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthetic medicines (local and general).
  • Tell your provider about all medicines you are taking. This includes prescriptions, over-the-counter medicines, and herbal supplements. You may need to stop taking these before the test.
  • Tell your healthcare provider if you have had a recent barium swallow or upper GI test. This may make it harder to get good X-rays of the lower GI area.
  • Follow any other instructions your provider gives you to get ready.

You may have a barium swallow as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your healthcare provider's practices.

Generally, a barium swallow follows this process:

  1. You'll be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.
  2. You may be asked to remove clothing. If so, you will be given a gown to wear.
  3. You will lie on an X-ray table that can move you from a horizontal to an upright position. You may also be asked to change positions during the test. For example, you may need to lie on your side, back, or stomach.
  4. The radiologist may take X-rays of your chest and belly (abdomen) first.
  5. The radiologist will ask you to take a swallow of a thick, chalky barium drink. The barium is usually flavored, but it may not taste very good.
  6. As you swallow the barium, the radiologist will take single pictures, a series of X-rays, or fluoroscopy to watch the barium moving through your mouth and throat.
  7. You may be asked to hold your breath at certain times during the test.
  8. You will be given a thinner barium drink to swallow. The radiologist will use X-rays or fluoroscopy to watch the barium go down your esophagus. You may also be asked to swallow a barium tablet. This is a small pill that can help to show certain problems in the esophagus.
  9. Once the radiologist has taken all of the X-rays, you'll be helped from the table.

You may go back to your normal diet and activities after a barium swallow, unless your healthcare provider tells you otherwise.

Barium may cause constipation or impacted stool after the procedure if it isn't completely cleared from your body. You may be told to drink plenty of fluids and eat foods high in fiber to help the rest of the barium leave your body. You may also be given a laxative to help with this.

Your bowel movements may be white or lighter in color until all the barium has left your body.

Call your healthcare provider right away if any of these happen:

  • Trouble with bowel movements or you are unable to have a bowel movement or pass gas
  • Pain or swelling of the abdomen
  • Stools that are smaller in size than normal
  • Fever

Your healthcare provider may give you other instructions, depending on your situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure


January 16, 2018


Contrast X-Ray of the Stomach: Gastric X-Ray Including Upper Gastrointestinal Examination (Upper GI Series, Barium Swallow, Esophagram). Fischbach Frances Talaska. A Manual of Laboratory and Diagnostic Tests. 2009;8:767–769.

Reviewed By:  

Lehrer, Jenifer, MD,Kolbus, Karin, RN, DNP, COHN-S