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1.
What is Upper Gastrointestinal (GI) Tract Radiography?
2. What is a Barium Enema?
3. How should I prepare for an upper GI or Small
Bowel exam?
4. How should I prepare for a Barium Enema examination?
5. What should I expect during my upper GI or
small bowel examination?
6. What should I expect during my Barium Enema
examination?
7. Are there any risks to the examination?
1. What is Upper Gastrointestinal (GI) Tract
Radiography?
Also called an upper GI, Upper Gastrointestinal
Tract Radiography is an x-ray examination of the esophagus,
stomach and first part of the small intestine. However, in order
for the anatomy to show up on radiographic images, the upper
gastrointestinal tract must be coated or filled with a contrast
material called barium, an element that appears bright white
on radiographs. The barium is given to the patient to drink.
For this reason, Upper Gastrointestinal Tract Radiography also
is called a barium-swallow x-ray. Additionally, some patients
are asked to swallow baking-soda crystals to create gas and
further improve the images; this procedure is called a “double
contrast” upper GI.
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2. What is a Barium Enema?
A barium enema is an x-ray examination
of the of the colon. In order for the anatomy to show up on
radiographic images, the upper colon must be coated or filled
with a contrast material called barium, an element that appears
bright white on radiographs. The barium is given to the patient
by rectum. Additionally, after the barium is administered, some
patients also have air insufflated into the rectum to create
gas and further improve the images; this procedure is called
a “double contrast” barium enema.
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3. How should I prepare for an upper GI or
Small Bowel exam?
The quality of the images obtained during
this procedure can be degraded if the stomach is not empty of
food. Therefore, you will likely be asked not to eat or drink
anything (including orally administered medications, especially
antacids) after midnight on the morning of the examination.
Nor should you chew gum or smoke after this time as these activities
can cause stomach secretions, which also may degrade the quality
of the images. Before the procedure begins, you will be asked
to remove all jewelry and also may be asked to wear a special
gown with no metal fasteners that could show up on the images.
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4. How should I prepare for a Barium Enema
examination?
Your doctor will give you detailed instructions
on how to prepare for your lower GI imaging. During the day
before the procedure, you will likely be asked not to eat, and
to drink only clear liquids like juice, tea, black coffee, cola,
or broth, and avoid dairy products. After midnight, you should
take nothing by mouth. You may also be instructed to take a
laxative (in either pill or liquid form) and to use an over-the-counter
enema preparation the evening, or even a few hours, before the
procedure. Just follow your doctor's instructions. Once you
arrive at the imaging center, you will be asked to change into
a gown before your examination. You will also be asked to remove
jewelry, eyeglasses, or any metal objects that could obscure
the images.
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5. What should I expect during my upper GI
or small bowel examination?
A technologist will position you on the
table. You may be asked to swallow baking-soda crystals (sometimes
called fizzies), which will create gas in your stomach. This
may make you feel like you need to belch. Then, you will be
given a cup of liquid barium, which resembles a light-colored
milkshake. As you drink, images will be taken. The barium may
have a chalky taste, but is flavored so that it tastes better.
The movement of barium is monitored by viewing gastrointestinal
tract on a fluoroscope, a device that projects radiographic
images in a movie-like sequence onto the screen monitor. First
you will be standing up, then lying down, as the radiologist
obtains pictures of your esophagus and stomach. You will be
asked to hold your breath to prevent blurring of the still images.
Also, periodically you will be asked to move into different
positions while standing, and to roll into different positions
while prone on the examining table. Still images are then obtained
as you move into different positions. The x-rays are absorbed
in varying amounts by the barium-coated gastrointestinal tract,
producing an image — similar to that from a photographic
camera — which is stored on film or on a computer.
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6. What should I expect during my Barium
Enema examination?
Once the patient is positioned on the
table, a preliminary film is obtained to check for adequacy
of the bowel preparation. The radiologist will then instill
contrast by inserting a small tube into the rectum. A mixture
of barium and water is passed into the patient's colon through
the tube. To help the barium thoroughly coat the lining of the
colon, air may also be injected through the tube. In some circumstances,
the radiologist or referring physician may prefer hypaque (a
water and iodine solution) rather than barium to opacify the
colon. Then a series of images is captured. As the barium fills
your colon, you may feel the need to move your bowels. You may
feel abdominal pressure, or even minor cramping. These are common
sensations, and most people tolerate the mild discomfort easily.
The tip of the enema tube is specially designed to help you
hold in the barium.
You may be repositioned frequently, to enable the radiologist
to capture views from several angles. During the study, the
radiologist will view the films and obtain special views or
close-ups.
Once the x-ray images are completed, most of the barium is drawn
back into a bag and the tube is removed from the rectum. The
patient is directed to the washroom to expel the remaining barium
and air. The technologist will then take additional images to
help the doctor see how well the colon has cleared.
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7. Are there any risks to the examination?
• Some patients may be allergic
to the flavoring added to some brands of barium. If you have
experienced allergic reactions after eating chocolate, certain
berries or citrus fruit, be sure to tell your doctor or the
technologist before the procedure.
• There is a slight chance that some barium could be retained,
leading to a blockage of the digestive system. Therefore, patients
who have an obstruction in the gastrointestinal tract should
not undergo this examination.
• The effective radiation dose from this procedure on
traditional equipment is about 2-4 mSv which is about the same
as the average person receives from background radiation in
8-16 months. At New Century Imaging, our digital fluoroscopy
unit allows studies to be performed at about 50% of this radiation
amount.
• Special care is taken during x-ray examinations to ensure
maximum safety for the patient by shielding the abdomen and
pelvis with a lead apron, with the exception of those examinations
in which the abdomen and pelvis are being imaged. Women should
always inform their doctor or x-ray technologist if there is
any possibility that they are pregnant.
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