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Barium Swallow
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Barium Swallow

A barium swallow is an imaging test that uses fluoroscopy and a contrast agent to visualize the upper gastrointestinal tract and diagnose swallowing or structural issues.

Overview

A barium swallow, also known as an esophagogram, is an imaging test used to examine the upper gastrointestinal (GI) tract, including the mouth, throat, esophagus, stomach, and the duodenum. Patients drink a chalky liquid containing barium, which coats the internal organs to make them visible on an x-ray. The procedure uses fluoroscopy, a type of x-ray that provides real-time video of internal organs in motion.

Uses

This test helps diagnose conditions affecting the upper GI tract, such as:

  • Ulcers
  • GERD (gastroesophageal reflux disease)
  • Hiatal hernia
  • Structural problems like polyps or diverticula
  • Tumors

Why It Is Performed

Providers order this test to investigate symptoms such as difficulty swallowing, abdominal pain, vomiting, or bloating.

The Procedure

The test is typically performed by a radiologist or radiology technician and lasts 30 to 60 minutes:

  • Patients may wear a hospital gown and a lead shield to protect the pelvic area.
  • The patient stands, sits, or lies on an x-ray table, potentially changing positions during the test.
  • The patient swallows a flavored, barium-containing liquid while the radiologist monitors the movement of the liquid through the GI tract via fluoroscopy.
  • Images are recorded for later review.

Preparation & Risks

Patients are usually required to fast after midnight before the test and avoid substances that coat the throat, such as gum or tobacco. Because the test involves radiation, it is not recommended for those who are or may be pregnant. Following the procedure, stools may appear white, and patients should drink fluids and eat high-fiber foods to prevent constipation caused by the barium.

Results

A normal result indicates no abnormalities in the size, shape, or movement of the upper GI tract. Abnormal results may reveal conditions such as hiatal hernias, ulcers, tumors, polyps, diverticula, or esophageal stricture. If esophageal cancer is suspected, a provider may follow up with an esophagoscopy, which uses a flexible tube with a camera to view the area and potentially collect tissue samples via biopsy.

Frequently Asked Questions

You should fast after midnight (no food or drink) and avoid chewing gum, smoking, or using throat lozenges on the day of the exam. These substances leave a coating on the mucosa that can interfere with the barium’s ability to outline the esophagus, potentially obscuring lesions or motility abnormalities.
Yes—barium can turn your stool white or gray for 1–3 days. To help clear it, drink plenty of clear fluids (water, juice) and eat high‑fiber foods (fruits, vegetables, whole grains). If you feel constipated, a mild stool softener or a glass of prune juice can be useful, but check with your provider if you have any bowel disorders.
Radiation exposure from a barium swallow is low but not zero. Because the fetus is especially sensitive to ionizing radiation, the test is generally avoided during pregnancy unless the diagnostic benefit outweighs the risk. If it’s essential, the radiology team uses lead shielding over the abdomen and limits fluoroscopy time to the shortest duration possible. Discuss alternatives (e.g., endoscopy) with your obstetrician and ordering physician.
Radiologists look for two main patterns: (1) Functional: a “sliding” or “reflux” of barium from the stomach into the esophagus, often with a widened hiatal opening, suggests GERD. (2) Structural: a fixed narrowing, irregular contour, or a pouch‑like outpouching indicates a stricture, ring, or diverticulum. The report will describe the location, length, and severity of any abnormality, which guides further management.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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