Barium X-ray

Understanding Gastrointestinal Tract

With Barium X-ray

Barium X-ray, also known as barium enema or barium swallow, is a medical imaging technique that involves the use of contrast agent barium sulfate to examine the inside of the upper gastrointestinal tract. The barium sulfate contrast agent is a chalky liquid or barium-containing food to enhance the visibility of the gastrointestinal tract on the X-rays. Barium X-ray plays an important role in radiology as it enables healthcare professionals to identify and assess gastrointestinal issues aiding in appropriate treatment and management. This diagnostic tool helps in the screening and diagnosis of gastrointestinal issues such as esophageal disorders such as reflex and ulcers, stomach issues such as ulcers, tumours, or gastritis, and small intestine disorders such as malabsorption disorders, Crohn’s disease or tumours.

Key Components of the Barium X-Ray:

Barium Enema: 

Barium enema, also known as lower gastrointestinal (GI) series, is a diagnostic imaging technique that uses a contrast agent containing barium sulfate to examine the large intestine (colon) and rectum. It is a helpful tool in diagnosing conditions and disorders affecting the lower GI tract. This test is often conducted to identify and evaluate abnormalities in the colon and rectum such as colorectal cancer, inflammatory bowel disease, diverticulitis, and colonic strictures.

Procedure: 

●       Before the procedure begins, the patient is asked to follow a set diet plan and perform bowel preparation to cleanse the bowel.

●       During the process, the patient is made to lie on the X-ray table and a tube is inserted into the rectum through which the contrast material is injected into the colon.

●       X-ray images are then taken as the barium fills the colon and outlines its structure highlighting any abnormalities.

●       Fluoroscopy is often used during barium enema.

●       The radiologists then assess the X-rays and screen for any polyps, tumours, or inflammation in the colon or rectum.

●       After the procedure, the patient is advised to drink a lot of water to eliminate the barium from the body.

Barium Small Bowel Follow-Through: 

A barium small bowel follow-through (SBFT) is an important diagnostic imaging procedure that involves the use of a contrast material containing barium sulfate to assess and examine the small intestine (small bowel). This imaging technique offers comprehensive and detailed X-ray images of the small bowel to detect and identify abnormalities such as obstructions, ulcers, tumours, malabsorption disorders, or inflammatory conditions. The imaging test is also used to monitor the progress of treatment for various gastrointestinal conditions that affect the small bowel.

Procedure: 

●       Before the procedure, patients might be instructed to fast for a certain period - particularly from midnight before the test. This fasting helps generate accurate images of the small bowel during the imaging.

●       On the day of the test, the patient is asked to drink a barium sulfate solution that coats the lining of the small bowel. The patient might be given a specific volume of the solutions to drink at set intervals.

●       X-ray images are then taken at various intervals as the barium travels through the small intestine. The barium then allows for the clear visualisation of the small bowel’s structure and function. Fluoroscopy is often used for barium small bowel follow-through.

●       Radiologists then review the X-ray and fluoroscopy images to assess the small bowel’s anatomy and function. Depending on the results of the scan, appropriate treatment action may be administered.

●       After the imaging is complete, the patient is allowed to resume their normal diet and activities and are often advised to drink plenty of water to eliminate the barium from the body.

Barium Swallow: 

A barium swallow, also known as an upper gastrointestinal (GI) series or esophagogram, is a valuable diagnostic imaging procedure that is often used to examine the upper gastrointestinal (GI) - including oesophagus, stomach, and duodenum (the first part of the small intestine). The imaging test involves the use of contrast material containing barium sulfate to enhance the visibility of these organs and their structures during the X-ray imaging. The test helps in identification and diagnosis of conditions such as gastroesophageal reflux disease (GERD), hiatal hernia, esophageal strictures, ulcers, tumours, and motility disorders.

Procedure: 

●       Patients are advised to fast overnight to enable clear visualisation of the upper GI tract during the imaging.

●       The patient is then asked to drink a barium sulfate liquid that has a chalky texture - which then coats the lining of the oesophagus, stomach, and duodenum to enhance their visibility on the X-ray images.

●       X-ray images are then taken at regular intervals allowing the barium to pass through these structures and patients may be asked to change positions during the X-ray imaging to obtain images from various angels and ensure a comprehensive view of the upper GI tract.

●       Fluoroscopy, a real-time X-ray imaging technique, is carried out during barium swallow as it allows observation of the flow of barium through the upper GI tract in real-time.

●       The images are then carefully analyzed by the radiologists and after determining the presence of abnormalities, they decide if further evaluation is needed.

MCU: 

MCU, also known as Micturating Cystourethrogram, is a specific type of radiological procedure used to visualise the urinary tract - specifically the bladder and urethra. It is not directly related to barium X-rays but is often performed using a contrast agent - typically a water-soluble iodinated contrast medium. The test is generally performed to evaluate the anatomy and function of the urinary tract and diagnose conditions such as vesicoureteral reflux, bladder abnormalities, urethral strictures, and other urinary tract abnormalities. It is also used to monitor the progress of treatment for various urinary tract conditions.

Procedure: 

●       Patients are typically instructed to arrive with a full bladder for the procedure to enable clear imaging of the organs.

●     The patient is then positioned on the X-ray table and a catheter is inserted into the bladder through the urethra. A water-soluble iodinated contrast medium is then introduced into the bladder through this urethra to allow visualisation of the bladder and urinary tract.

●       X-ray images are taken as the patient empties the bladder which allows the radiologist to observe the flow of the contrast medium through the urinary tract.

●       Fluoroscopy is also used during an MCU as it offers continuous imaging to observe the flow of contrast in real-time.

●       The images also capture the anatomy of the kidney in some cases along with bladder and urethra.

●       Radiologists then carefully review the X-ray and fluoroscopy images to assess and determine if any abnormalities are seen in the function and anatomy of the bladder and urethra.

●    After the imaging is complete, the catheter is removed and patients may be advised to empty their bladder completely to ensure the contrast medium is properly eliminated from the body.