The barium meal and swallow procedures provide doctors with X-ray images of your gut so they can identify any problems that might be causing symptoms such as indigestion and other pain.
A referral letter from a consultant or GP is required before booking any diagnostic investigation.
Why you might need it
Many of us are affected by debilitating and painful digestion problems. Yet doctors find it difficult to examine the gut (the oesophagus and stomach) because it is difficult to get detailed images of this part of the body on X-rays.
By covering it with barium, a soft white reactive metal that is safe to consume, clinicians can get much better X-ray images and identify problems. These could include:
- ulcers
- inflammation
- an obstruction
These tests can also help doctors diagnose cancer. A stomach ulcer alone can cause quite intense pain as well as indigestion and heartburn. Diagnosis is the first step towards getting the treatment you need. You should not take this test if you're pregnant as it exposes you to a low level of radiation.
You start the procedure by consuming barium and it usually lasts around 20 minutes. With a barium meal, images will be taken of your stomach while a barium swallow and meal allows clinicians to take pictures of your oesophagus as well.
We pride ourselves on our clinical excellence, you'll be looked after by an experienced multidisciplinary care team.
Find a Spire hospital offering this treatment
Who will do it?
Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.
All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.
Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.
Before your treatment
You will need a referral letter from a consultant or GP before booking any diagnostic investigation.
You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
A formal consultation may not always be required for all patients.
Preparing for your treatment
We've tried to make your experience with us as easy and relaxed as possible.
For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.
Our dedicated team will also give you tailored advice to follow in the run up to your visit.
Talk to your doctor about whether you need to adapt any medication you are taking before the procedure. Never stop taking prescribed medicines without talking to a doctor.
The procedure
One of our experienced and caring staff will ask you to drink a white liquid containing barium in an X-ray room.
It’s fruit flavoured and you’ll need to sip it rather than gulp it.
We'll temporarily expand your stomach and will do this by asking you to swallow a spoon of granules. You might also be given a muscle relaxant injection to prevent the stomach moving while the images are taken.
The radiographer will then take images. You might be asked to swallow or hold your breath at various points and the table you’re on will tilt during the procedure. This means you'll gradually tilt from sitting to lying down.
Aftercare
You may feel bloated for a few hours and it's likely you'll be constipated for a few days. Talk to your pharmacist about a mild laxative. Drink plenty of water and eat high fibre foods such as fresh fruit and veg, rice and wholemeal pasta to get things moving.
Some people have an allergic reaction to the flavouring added to the barium drink. Before you leave, we'll advise you on what to look out for and what medicines are available to treat any allergic reaction.
If you experience any itching or difficulty in breathing tell your radiographer immediately. Ask your doctor to explain how these risks apply to you. The exact risks will differ for every person.
A report will be sent to the doctor who requested your test. The report can take several days to reach your doctor. Before you go home, please ask your radiographer when you can expect to get your results.
If you haven't been told the results of your X-ray within two weeks, you should call the doctor who requested your test.
Why choose Spire?
We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.
Important to note
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.
What is a barium swallow?
A barium swallow can help diagnose problems with the back of your mouth and throat (pharynx) and your gullet (oesophagus) using a special X-ray.
It involves taking X-ray images of your stomach and oesophagus after you’ve drunk a harmless liquid metal called barium contrast. The barium coats your stomach and oesophagus so they show up clearly on the X-ray image. This allows a doctor or radiologist to see a detailed outline of these digestive organs and diagnose any problems.
It is also known as a barium X-ray or barium meal.
Barium swallow vs. endoscopy
An endoscopy is more invasive than a barium swallow as a special tube called an endoscope needs to be passed down through your mouth, down your throat and into your gullet. A barium swallow doesn't require any devices to be passed into your body, you only need to drink a special liquid metal called barium contrast and then have an X-ray.
Both an endoscopy and barium swallow are helpful to diagnose problems with your gastrointestinal system. Some of these disorders can be diagnosed easily using an X-ray with a barium swallow. However, more complex problems may need an endoscopy.
How do I know if I need a barium swallow?
Your doctor may recommend a barium swallow to investigate the cause of symptoms such as:
- Abdominal pain and bloating
- Digestion problems
- Frequent, painful heartburn
- Painful swallowing
- Unexplained weight loss
- Vomiting
A referral letter from a consultant or GP is required before booking any diagnostic investigation.
What does a barium swallow show?
Common conditions affecting your oesophagus and stomach that can be diagnosed with a barium swallow are:
- An obstruction or narrowing of your oesophagus
- Gastro-osophageal reflux disease (GORD)
- Hiatus hernia
- Structural problems with your gut — this includes abnormal growths (polyps) and abnormal pouches in your intestinal wall (diverticula)
- Stomach ulcers
- Swallowing disorder (dysphagia)
A barium swallow can also identify inflammation, as well as more serious conditions, such as stomach cancer.
A barium swallow can be used to image movement through your gastrointestinal system too, using a continuous X-ray beam (fluoroscopy).
Sometimes a barium swallow is performed alongside a special kind of endoscopy of the upper gastrointestinal system called an oesophagogastroduodenoscopy (OGD). Barium swallows are also often part of a series of tests to investigate the upper gastrointestinal system and small intestine.
Where to get a barium swallow
Many of our hospitals offer the barium swallow test and our fast diagnostics mean you won’t have to wait long for your results. Find your nearest Spire hospital.
Preparing for a barium swallow
Before your barium swallow, you will be given instructions by your healthcare team on how to prepare. They will tell you not to eat or drink anything for six hours before your barium swallow. However, you can take small sips of water up to two hours before your barium swallow. You may also be advised not to chew gum, eat mints or smoke after midnight the night before your procedure.
If you are having other tests performed or you have certain medical conditions, you may receive slightly different instructions from your healthcare team.
Certain conditions may prevent you from having a barium swallow due to the risk of complications. These conditions include:
- A perforated oesophagus or bowel
- Bowel obstruction
- Difficulty swallowing
- Severe constipation
If you have or previously had any of these conditions, make sure you tell your healthcare team.
Barium swallow procedure
It can be difficult to see your stomach and oesophagus clearly in a normal X-ray, which is where a barium swallow can help.
Getting ready for your barium swallow
You may be asked to change into a hospital gown and will also be given a lead shield or apron to wear over your pelvic area to shield it from unnecessary X-ray radiation.
You may be asked to take several different positions during your procedure, including standing, sitting or lying down on an X-ray table.
During your barium swallow
One of our experienced and caring staff will ask you to drink a white liquid containing barium in an X-ray room. It’s fruit flavoured and you’ll need to sip it rather than gulp it. This liquid will coat the lining of your oesophagus and stomach, allowing these structures to be captured more clearly on X-ray images.
As you swallow mouthfuls of this liquid, single X-ray images, a series of X-ray images or continuous real-time X-ray images (fluoroscopy) will be captured of the barium contrast passing down your throat and into your oesophagus. These images will be stored so your doctor can review them later.
You might also be given a muscle relaxant injection to prevent the stomach moving while the images are taken.
Next, the procedure will be repeated but instead of drinking a thick barium contrast liquid, you will drink a thinner version.
After your barium swallow
Once all the X-ray images needed have been taken, you can change back into your normal clothes and go home. You can immediately return to your usual activities, including eating and drinking, unless your doctor advises against it.
You may feel bloated for a few hours and it's likely you'll be constipated for a few days. Talk to your pharmacist about a mild laxative. Drink plenty of water and eat high fibre foods such as fresh fruit and veg, rice and wholemeal pasta to get things moving.
What does a barium swallow taste like?
Barium contrast is artificially sweetened and flavoured (eg chocolate or strawberry flavoured) to make it more palatable to drink. However, you may still find that it tastes bitter or chalky.
How long does a barium swallow take?
A barium swallow takes about 20 minutes, although it can be longer. You can go home shortly afterwards.
Barium swallow results
A radiographer will carry out your barium swallow. A report will be sent to the doctor who requested your scan. This can sometimes take a few days, though we try to get your results to you as quickly as possible. Your radiographer will let you know when you can expect to get your results.
Barium swallow side effects and risks
Risks of X-rays
A barium swallow procedure involves the use of X-rays, which are a type of ionising radiation. However, the doses used in medical X-rays are very low — the amount of radiation is the same as the background radiation you’d naturally be exposed to over a few years. It's thought exposure to X-rays may slightly increase your chances of developing cancer many years later, although this risk is thought to be very small.
Nonetheless, X-rays aren't recommended for pregnant women.
At Spire Healthcare, we’re careful to weigh up the benefits and risks of any X-ray and discuss it with you if you have any concerns.
Risks and side effects of barium contrast
There are no known risks associated with the barium contrast liquid and it passes through your body without being absorbed. However, if the barium doesn't promptly completely pass out of your body after your procedure, it can cause temporary constipation.
To avoid the risk of constipation, drink plenty of fluids and eat high-fibre foods after your procedure as these will both help the barium contrast move through your gut and out of your body. If you are still constipated, your doctor may prescribe a laxative.
You may notice that your stools are lighter after your barium swallow. This is due to the barium passing out of your body and once it has all been expelled, your stools will return to their normal colour.
If you have an existing swallowing difficulty, there is a small risk of breathing a small amount of liquid into your lungs (aspiration).
When to see your doctor
If after your procedure, you experience any of the following, you should see your doctor:
- Abdominal pain or bloating
- Difficulty passing stools
- Inability to pass stools
- Stools that are smaller in diameter than usual
Barium swallow and diabetes
As you should not eat or drink for six hours before your barium swallow, if you have diabetes, your doctor will arrange for your procedure to occur in the morning.
If you manage your diabetes by taking tablets, your doctor will tell you not to take your medication before your barium swallow. However, once your procedure is complete, you should take your tablets and have some food.
If you manage your diabetes by taking insulin injections, your doctor will tell you not to take your morning injection and in some cases, not to take your insulin injection the evening before your procedure too. However, once your procedure is complete, you should take your insulin injection and have some food.
If you take long-acting insulin, your doctor will tell you to continue to take your insulin injections as normal.
Frequently asked questions
Does a barium swallow test hurt?
No, a barium swallow test does not hurt and is not an invasive procedure. You will need to drink a liquid called barium contrast, which can taste bitter and chalky but is not painful. X-ray images will then be taken, which are also not painful.
Does a barium swallow show acid reflux?
Persistent acid reflux ie gastro-oesophageal reflux disease (GORD) cannot always be detected using a barium swallow. This is because only around a third of people with GORD show structural changes in their gullet (oesophagus) that a barium swallow can reveal.
How much barium do you drink for a barium swallow?
You will need to drink around two cups — approximately 500ml — of barium contrast liquid.
Is an oesophagram the same as a barium swallow?
Yes, an oesophagram is the same as a barium swallow.
How do you flush barium out of your system?
Barium is not absorbed by your body so it will naturally pass out of your body. However, to speed up the process, drink lots of fluids and eat high-fibre foods.
How long does it take for barium to pass through your system?
Barium will pass through your gut over several hours. It will then be expelled from your body via your stools, which can take a couple of days.
Do you have to drink all the barium for a CT scan?
Yes, you will need to drink all of the barium given to you, which will be around two cups (500 ml). As you swallow mouthfuls of the liquid, X-rays will be taken to capture images of the barium liquid as it coats your gullet (oesophagus) and stomach.
What are the signs of dysphagia?
Dysphagia refers to problems swallowing. For some, certain foods and drinks are difficult to swallow, while for others swallowing anything is impossible.
Signs include coughing or choking when swallowing food or drink, bringing up food through your mouth or nose, feeling as if something is stuck in your throat or chest, persistent drooling, difficulty chewing food and a gurgling voice when eating or drinking. In the long term, dysphagia can also cause weight loss and chest infections.
How accurate is barium swallow?
The accuracy of a barium swallow will depend on what gastrointestinal problem is present. A barium swallow shows gastrointestinal structures, such as your gullet (oesophagus) and stomach, more clearly than a standard X-ray.
Can dysphagia be caused by anxiety?
Yes, difficulty swallowing can be caused or made worse by anxiety or panic attacks.
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.