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Upper GI and small bowel series

GI series; Barium swallow x-ray; Upper GI series

An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine.

Barium enema is a related test that examines the large intestine.

Images

Barium ingestion
Stomach cancer, X-ray
Stomach ulcer, X-ray
Volvulus - X-ray
Small intestine

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How the Test is Performed

An upper GI and small bowel series is done in a health care office or hospital radiology department.

You may get an injection of a medicine that slows muscle movement in the small intestine. This makes it easier to see the structures of your organs on the x-rays.

Before the x-rays are taken, you must drink 16 to 20 ounces (480 to 600 milliliters) of a milkshake-like drink. The drink contains a substance called barium, which shows up well on x-rays.

An x-ray method called fluoroscopy tracks how the barium moves through your esophagus, stomach, and small intestine. Pictures are taken while you sit or stand in different positions.

The test most often takes around 3 hours but can take as long as 6 hours to complete.

A GI series may include this test or a barium enema.

How to Prepare for the Test

You may have to change your diet for 2 or 3 days before the test. In most cases, you will not be able to eat for a period of time before the test.

Be sure to ask your health care provider if you need to change how you take any of your medicines. Often you can continue taking the medicines you take by mouth. Never make any changes in your medicines without first talking to your provider.

You will be asked to remove all jewelry on your neck, chest, or abdomen before the test.

How the Test will Feel

The x-ray may cause mild bloating but no discomfort most of the time. The barium milkshake feels chalky as you drink it.

Why the Test is Performed

This test is done to look for a problem in the structure or function of your esophagus, stomach, or small intestine.

Normal Results

A normal result shows that the esophagus, stomach, and small intestine are normal in size, shape, and movement.

Normal value ranges may vary depending on the lab doing the test. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results in the esophagus may indicate the following problems:

Abnormal results in the stomach may indicate the following problems:

Abnormal results in the small intestine may indicate the following problems:

The test may also be done for the following conditions:

Risks

You are exposed to a low level of radiation during this test, which carries a very small risk for cancer. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.

Pregnant women should not have this test in most cases. Children are more sensitive to the risks for x-rays.

Barium may cause constipation. Talk to your provider if the barium has not passed through your system by 2 or 3 days after the exam.

Considerations

The upper GI series should be done after other x-ray procedures. This is because the barium that remains in the body may block details in other imaging tests.

Related Information

X-ray
Barium enema
Esophageal cancer
Esophageal stricture - benign
Hiatal hernia
Diverticulitis
Ulcers
Achalasia
Stomach cancer
Mucosa
Gastritis
Pyloric stenosis - infant
Malabsorption
Crohn disease
Alcoholic neuropathy
Annular pancreas
CMV - gastroenteritis/colitis
Cystic fibrosis
Peptic ulcer
Gastroesophageal reflux disease
Gastroparesis
Intestinal obstruction and Ileus
Lower esophageal ring
Ovarian cancer
Intestinal pseudo-obstruction

References

Caroline DF, Dass C, Agosto O. The stomach. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 27.

Kim DH, Pickhardt PJ. Diagnostic imaging procedures in gastroenterology. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 133.

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Review Date: 10/27/2018  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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