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Fluoroscopy Upper GI (aka Esophogram)

Fluoroscopy uses a continuous or pulsed x-ray beam to create a sequence of images that are projected onto a television-like monitor. When used with a contrast material (which defines the area being examined by making it appear dark or by electronically reversing the image contrast to white), this special X-ray technique makes it possible for the physician to view joints or internal organs in motion. Still images or movies are also captured and stored electronically on a computer.

What to Bring

  • Your physician order
  • Personal identification
  • Insurance card(s)
  • Medication list

How to Prepare for Your Fluoroscopy Exam (Upper GI)

  • If there is any chance you may be pregnant, your exam should be postponed until the start of your period or within 10 days after. If there is any possibility that you are pregnant, you should always inform your X-ray technologist.
  • If you are having an esophagus, stomach, or duodenum and/or small bowel fluoroscopy, do not eat or drink anything including water after midnight before your exam.
  • Certain exams can take as long as 4 hours.
  • If you have an on-body device (insulin pumps, insulin regulators, Neulasta, other chemo pumps, etc), you must inform your X-ray technologist. These devices cannot be in the X-ray room during your exam.

How to Prepare for Your Upper GI Exam

  • Please let your physician know about any medications you are taking and if you have any allergies, especially to contrast materials.
  • Please inform your doctor about recent illnesses or other medical conditions.
  • Your stomach must be empty of food to ensure the best possible image quality.
  • Do not eat or drink anything including water after midnight before your exam.
  • Morning of: you should take your usual prescribed oral medications with limited amounts of water.
  • Do not chew gum or smoke after midnight on the day of the examination.
  • Leave all valuables at home.
  • You will be given a gown to wear during the procedure. You may be asked to remove jewelry, glasses and any metal objects or clothing that might interfere with the X-ray images.
  • After the procedure, drink plenty of clear fluids.

What to Expect

  • The upper GI examination is usually done on an outpatient basis and is often scheduled in the morning to reduce the patient's fasting time.
  • Upper gastrointestinal tract radiography or “Upper GI” uses a form of real-time X-ray called fluoroscopy and a barium-based contrast material or a water soluble iodinated contrast to produce images of the esophagus, stomach and small intestine.
  • It is safe, noninvasive, and may be used to help accurately diagnose pain, acid reflux, blood in the stool and other symptoms.
  • As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a type of X-ray called a fluoroscope unit.
  • The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. The patient may also be asked to turn into different position on the table to obtain what is needed for the exam.
  • Once the upper GI tract is adequately coated with the barium, additional still X-ray images may be taken.
  • This exam is usually completed within 20 minutes. If a Small Bowel Exam is also performed, then the exam could take up to 4hrs.
  • Infants will drink barium contrast material via a bottle that is provided by the facility. Children usually drink barium contrast material without any objections.
  • Adults and older children may undergo a double-contrast upper GI series. The patient will swallow baking-soda crystals that create gas in the stomach while additional X-rays are taken.

What will I experience during and after the procedure?

  • Occasionally, patients find the thick consistency of the barium unpleasant and difficult to swallow. The liquid barium has a chalky taste that may be masked somewhat by added flavors such as strawberry or chocolate.
  • Being tilted on the examination table and having pressure applied to the abdomen can be uncomfortable for some patients. The examination may also make you feel bloated.
  • If you receive gas-producing crystals, you may feel the need to belch. However, the radiologist or technologist will tell you to try to hold the gas in (by swallowing your saliva if necessary) to enhance the detail on the x-ray images.
  • In some medical centers, the technologist can minimize patient movement by automatically tilting the examining table. These actions ensure that the barium is coating all parts of the upper GI tract. As the procedure continues, the technologist or the radiologist may ask you to drink more barium. You may hear the mechanical noises of the radiographic apparatus moving into place during the exam.
  • After the examination, you can resume a regular diet and take orally administered medications unless instructed otherwise by your doctor.
  • The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. If you are unable to have a bowel movement or if your bowel habits undergo any significant changes following the exam, you should contact your physician.

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