Barium meal
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A barium meal, also known as an upper gastrointestinal series is a procedure in which radiographs of the esophagus, stomach and duodenum are taken after barium sulfate is ingested by a patient. Barium meals are useful in the diagnosis of structural and motility abnormalities of the foregut.
A barium meal takes less than an hour on average. The technician will ask the patient to swallow gas pellets and citric acid to expand the stomach. Barium sulfate, a compound of barium, is then ingested (pure barium, a heavy metal, is potentially toxic). Afterwards, the patient may move or roll over to coat the stomach and esophagus in barium, and an x-ray is taken. A needle might also be used to relax the muscle between the stomach and the duodenum.
Liquid Barium compounds usually have a chalky taste that can be disguised by adding flavours[1].
The gastrointestinal tract, in common with all other soft-tissue structures throughout the body does not show clearly enough for diagnostic purposes on plain radiographs. Barium salts are completely radio-opaque, and therefore show very clearly on a radio graph. They are also wholly non-toxic, apart from a small risk of producing a disturbance in bowel function for 48 hours after ingestion. If barium is swallowed and radiographs are taken, the barium within the esophagus, stomach or duodenum shows the shape of the lumina of these organs.
There are two varieties of barium meal, these being single and double contrast meals. A single contrast meal uses only barium, a radiopaque (or positive) contrast medium, to image the upper gastrointestinal tract while a double contrast meal uses barium as well as a radiolucent (or negative) contrast medium such as room air, nitrogen, or carbon dioxide. The double contrast meal has the advantage of demonstrating mucosal details and is much more useful as a diagnostic test allowing the detection of small mucosal lesions such as diverticula or polyps.
The diagnostic usage of barium studies has declined in recent years with the increasing use of the practice of endoscopy, which allows direct visual inspection of suspicious areas within the oesophagus, stomach and duodenum.
