A barium swallow, also known as an esophagogram is a special type of X-ray procedure that checks for problems in the upper GI tract which includes the mouth, back of the throat, oesophagus, stomach and first part of the small intestine. This test evaluates the root cause of pain and difficulty swallowing, abdominal pain, blood-stained vomit, or sudden weight loss. Barium swallow test helps the healthcare provider to have a comprehensive look at the structure of the mouth and throat (pharynx) and tube that extends from the back of the tongue to the stomach, (oesophagus). The test uses a special type of X-ray called fluoroscopy, which shows the movement of the internal organs in real-time.
Barium swallow - Esophagram

The doctor may suggest a barium swallow to diagnose any structural or functional problem in the upper gastrointestinal tract. Some of the common disorders that a barium swallow may help diagnose include:

Hiatal hernia



Muscle disorders or spasms

Structural problems in the GI tract, such as polyps and diverticula

Gastroesophageal reflux disease (GERD)



A continuous X-ray beam, called fluoroscopy is used for the X-ray to capture movement via the GI tract. Sometimes a person may also need an upper GI endoscopy for further evaluation. Barium swallows are often done as part of upper GI and small bowel series of tests.

Also Read: Do I Have Irritable Bowel Syndrome?

How To Prepare For A Barium Swallow?

Before the test, it’s vital to adhere to the dietary guidelines recommended by a doctor. The patient is not supposed to eat or drink anything for 6 hours before the procedure, however, the patient can have small sips of water until two hours before the test.

It is necessary to inform the doctor about any pre-existing disease conditions before the procedure:

An oesophageal or bowel perforation

Bowel obstruction

Difficulty swallowing

Severe Constipation

These problems may prevent the patient from taking the test, as they can increase the risk of complications.

What To Expect?

A trained radiology technician will carry out the procedure and it takes about 30 minutes to complete the test. The patient will be asked to remove the clothing and all jewellery and wear a medical gown. The technician will position the patient on an X-ray table, they may ask the patient to move the body position as they capture regular X-rays of the heart, lungs, and abdomen. Then the technician will provide the patient with a barium drink to swallow and will again take the X-rays to see how barium travels down the oesophagus. Next, the patient will be asked to drink thinner barium to swallow and will again take X-rays or fluoroscopy to see how the barium moves down the oesophagus. When all the X-rays are completed, the patient can go home and carry out daily activities and have a normal diet, unless a doctor advises otherwise. The results will be given after a few days.

What Does The Results Mean?

A normal study result indicates that no abnormalities were seen in size, shape and movement in the throat, oesophagus, stomach or first part of the small intestine. On the other hand, if the results were not normal, it may indicate that patient may have one of the following problems:

Hiatal hernia





Oesophageal stricture, a narrowing of the oesophagus that can make it hard to swallow.

Are There Any Risks To The Test?

If the barium is not fully expelled from the body after the procedure, it may at times cause constipation, thus one should drink plenty of fluids and have fibre-rich foods to aid the barium move via the GI tract and out of the system. If that doesn’t help, the doctor may give a laxative to help the barium be removed out.

Post-procedure, one may notice that bowel movements are lighter in colour, as the body doesn’t absorb the barium and stool will return to its normal once all the barium has been expelled.

After your procedure, you might notice that your bowel movements are lighter in colour. This happens because your body doesn’t absorb the barium. Your stool will return to its normal colour once all the barium has been expelled.

For all others, there is little risk to taking this test, as the radiation level is very minimal and not considered harmful for most people. This risk of radiation exposure accumulates over the period and are associated with the number of X-rays and radiation treatments a person receives.

One should not go for this test if pregnant or think you may be pregnant, as radiation can be quite harmful to the unborn foetus.