• Upper Gastrointestinal Series (UGI)

    Estimated time: Two to three hours (most of the estimated time is spent waiting for the passage of the barium)

    Anatomy involved: Esophagus, stomach, duodenum, and small bowel

    Performed by: Radiologist (physician), technologist, fluoroscopy assistant

    Preparation: No food, liquids or oral medications from 12 midnight to time of examination. Patients with ostomies having GI studies should bring extra bags.  


    Preparation: One hour

    Anatomy involved: Esophagus, stomach, and duodenum

    Performed by: Radiologist (physician), technologist, fluoroscopy assistant

    Preparation: No food, liquids or oral medications from 12 midnight to time of exam. Patients with ostomies having GI studies should bring extra bags.

    The upper gastrointestinal (UGI) series is a fluoroscopic and X-ray examination of most of your digestive system, including the esophagus (swallowing structure), stomach, duodenum (first portion of the small bowel), and small bowel, which is approximately 15-feet long. To better delineate these structures during the procedure,a contrast medium or "dye" called barium is ingested to outline and coat the walls of the digestive system. A second substance called bicarbonate powder is also ingested, producing gas that serves to aid in visualization of these structures during the exam. 

     Stomach Duodenum             Small Bowel Series

    Before and During the Exam

    Before the test begins, a technologist will take one or two X-rays of your abdomen -a "before barium" picture. After these films are checked, a fluoroscopy assistant will bring you into the room with a special scanning X-ray unit called a fluoroscope. 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 fluoroscopy, the radiologist is able to view the structures being examined in real time and take X-rays of particular areas of interest. The fluoroscopy assistant will briefly explain the exam and then notify the radiologist that you are ready for your test.

    The radiologist will then review your record to determine the best method of examination. In certain cases, the radiologist will administer glucagon intravenously just before the beginning of the examination. Glucagon is a normal product in the body secreted by the pancreas. It slows digestive movements for approximately five to 10 minutes, enabling the radiologist to better view the stomach without motion. The end result is an image with better detail and slightly less radiation. In rare cases, glucagon may cause mild, momentary cramping.

    While you are in a standing position, the radiologist will give you two cups, one containing bicarbonate powder and the other, barium. The liquid barium has somewhat of a chalky taste masked by added flavors such as strawberry. The powder is ingested first, quickly, followed by the barium. The gas producing powder will make you feel the need to belch. However, you should hold the gas in (by swallowing your saliva if necessary), as its presence in the stomach greatly enhances the detail of the radiographic images.

    You will then be placed in a reclining position on the X-ray table. The radiologist will have you move in different positions to manipulate the gas and barium and to get a clearer picture of the anatomy involved. The radiologist may apply mild focal pressure to parts of your abdomen during the examination to better visualize certain structures.

    When the radiologist is finished, you will be asked to drink more barium and have X-rays at specifically timed intervals to follow the progression of the barium through the small bowel until it reaches the large bowel. The time required to accomplish this varies with each individual and depends on how rapidly the digestive process functions. A technologist will call you from the waiting area each time a film is due to be taken.

    When the barium has made its way to the end of the small bowel, you may be asked to return to the fluoroscopy room for a brief period so that the radiologist may visualize your most distant small bowel with the fluoroscope and take another X-ray. The examination will then be complete and will be interpreted by the radiologist. You may then take your chart and proceed to your next appointment. 

    After the Exam

    After the exam you can resume a regular diet and take orally administered medications unless told otherwise by your doctor. The barium may color stools gray or white for 48 to 72 hours after the procedure. You are encouraged to drink additional water during this time to help pass the barium. In rare instances, the barium can cause temporary constipation, which is usually well treated with an over-the-counter laxative.

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