Estimated time: 30 minutes Anatomy involved: Hypopharynx (throat) and esophagus Performed by: Radiologist (physician), fluoroscopy assistant Preparation: None required
The barium swallow (BaSw) is a fluoroscopic and X-ray examination of your hypopharynx (throat) and esophagus (the tube that connects your throat to your stomach). To better delineate these structures during the procedure, a contrast medium or dye called barium is ingested, which outlines and coats the walls of the throat and esophagus.
At the beginning of the examination, a fluoroscopy assistant will bring you into a room where the fluoroscope is located. A fluoroscope is a device equipped with a fluorescent screen on which the internal structures of an optically opaque object, such as the human body, may be continuously viewed as shadow-like images formed by the transmission of X-rays through the object. Using this technology, the radiologist is able to view the internal organs being examined in real time and take X-rays of particular areas of interest. The fluoroscopy assistant will briefly explain the examination and then notify the radiologist that you are ready for your test. While you are in a standing position, the radiologist will give you a cup of barium. You will be asked to swallow the barium while the radiologist uses the fluoroscope to watch the barium pass through your throat and assess your swallowing function. The liquid barium has somewhat of a chalky taste masked by added flavors such as strawberry. The radiologist will take pictures or X-rays during the act of swallowing and after the barium is swallowed, while you are at rest. You will then be positioned at right angles, and the process will be repeated in order to get two views of the hypopharynx. Finally, you will be asked to swallow the barium one more time and the radiologist will move the fluoroscope over your chest to observe your esophagus and obtain a few more X-ray images.
The examination will then be complete. The radiologist will interpret the results of the exam and have them forwarded to your referring physician. After the examination, you can resume your normal activities. The barium may color stools gray or white for a day or two after the procedure, but this is entirely normal and is no cause for concern. In rare instances, the barium can cause temporary constipation which is usually well treated with an over-the-counter laxative. A modified barium swallow is a similar exam to the one described above, but it is coordinated with, and attended by, a speech pathologist. In addition to the maneuvers described above, the patient is also generally observed under fluoroscopy while swallowing liquids of varying thickness and while swallowing solids containing barium.