Background Information:

What are the other Names for the Procedure?

• Double Contrast Upper GI Series
• Upper Gastrointestinal Series
• Upper Gastrointestinal Tract Fluoroscopy

What is Upper GI Series radiology procedure? (General Explanation)

• An Upper Gastrointestinal (GI) Series radiology procedure is a real-time X-ray video of the esophagus, stomach, and portion of the beginning of the small intestines
• The individual will be asked to ingest a small amount of food or liquid that contains barium sulfate. Barium sulfate is a contrast material that helps outline the digestive tract on an imaging study
• In case a small amount of baking soda crystals, similar to Alka-Seltzer, are additionally ingested (which will add air to the GI tract), it can make the scan a double contrast study
• An Upper GI Series may be coupled with either a barium swallow procedure or a small bowel follow through study procedure, to further investigate the digestive tract

What part of the Body does the Procedure involve?

An Upper GI Series radiology procedure involves the esophagus, stomach, and the first part of the small intestines (duodenum).

Why is the Upper GI Series radiology procedure Performed?

An Upper GI Series radiology procedure can be used to detect or diagnose the following conditions:

• Structural abnormalities such as polyps, narrowing, or out-pouching of the esophagus
• Tumors in the stomach or esophagus
• Hiatal hernia
• Chest or abdominal pain
• Gastro-esophageal reflux disease (GERD)
• Unexplained severe vomiting

What are the Alternative Choices for the Procedure?

Undergoing an upper GI endoscopy is a potential alternative to an Upper GI Series radiology procedure.

What is the Equipment used? (Description of Equipment)

The following equipment is used for the Upper GI Series procedure:

• A continuous X-ray machine (fluoroscopy) with an attached computer monitor
• Food or liquid contacting barium

What are the Recent Advances in the Procedure?

There have been no recent advances to an Upper GI Series radiology procedure.

What is the Cost of performing the Upper GI Series radiology procedure?

The cost of an Upper GI Series procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Upper GI Series and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Watson N. Gastrointestinal tract. In: Chapman & nakielny's guide to radiological procedures. 6th ed. Philadelphia, PA: ; 2014:47-96.

Prior to Upper GI Series radiology procedure:

How does the Upper GI Series radiology procedure work?

• An Upper GI Series uses continuous X-ray’s to create a short video. X-ray radiation passes through the body and is recorded on a specialized film
• The ingested barium helps outline the GI tract making the structures of the digestive tract more visible

How is the Upper GI Series radiology procedure Performed?

The Upper GI Series radiology procedure is performed in the following manner:

• The individual is asked to stand on or sit at an exam table near a specialized camera
• A small amount of food or liquid that contains the contrast media (barium that helps outline the digestive tract) is administered
• As the barium is swallowed, the radiologist positions the camera to capture various images, to visualize the digestive system, while following the path of the barium

Where is the Procedure Performed?

The Upper GI Series radiology procedure is performed as an inpatient or outpatient procedure depending on the specific indication (or reason for the procedure being performed).

Who Performs the Procedure?

An Upper GI Series radiology procedure is generally performed by a radiologist.

How long will the Procedure take?

The imaging time of the Upper GI Series radiology procedure usually takes about 20 minutes.

Who interprets the Result?

The radiologist interprets the image and reports to the patient's healthcare provider, who will convey the information to the patient.

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to an Upper GI Series radiology procedure:

• The individual may be asked to keep their stomach empty prior to the procedure. This will involve avoiding eating, drinking, or even chewing gum, after midnight of the day before the procedure is to take place
• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are currently being taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• Women should notify the physician if they are pregnant or breastfeeding their child; as many such procedures, may not be performed on pregnant women
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations before the preparation sessions
• It is recommended to notify the physician about any implants or metal objects in the body, such as a pacemaker, nerve simulators, surgical staples, or artificial heart valves, braces, or dyed tattoos, as they may interfere with the imaging, in some cases
• The patients are given specific instructions depending upon the study being performed

What is the Consent Process before the Procedure?

A physician will request your consent for the Upper GI Series procedure using an Informed Consent Form.

Consent for the procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Upper GI Series procedure:

• It is a non-invasive procedure
• Barium, used as a contrast material in the procedure, is not absorbed in blood; thus, having allergic reactions due to barium is very rare
• The radiation used in the procedure does not stay in the patient’s body after the exam
• The examination results can provide detailed information on any abnormalities related to the pharynx, esophagus, stomach, and duodenum

Following are the risks of the Upper GI Series procedure:

• Due to exposure to radiation during the procedure, there is a minimal risk for developing cancer
• Very rarely, barium used in the procedure may lead to an obstruction in the digestive system. This effect can be minimized by consuming appropriate amounts of fluids following the procedure

What are the Limitations of the Upper GI Series radiology procedure?

Following are the limitations of the Upper GI Series procedure:

• The test may be useful to detect large ulcers, but is not very effective in detecting ulcers smaller than ¼ inch in diameter (less than 6 mm)
• It may be difficult to detect mild irritation in the stomach and esophagus
• Biopsies cannot be performed using this examination
• In order to confirm the presence of infectious bacteria in ulcers, additional blood tests or biopsies may be needed

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is an Upper GI Series procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Upper GI Series radiology procedure:

What is expected during the Upper GI Series radiology procedure?

The following may be expected during an Upper GI Series procedure:

• While the amount of ionizing radiation exposure is low, the staff will be wearing protective gear including a lead gown, to protect themselves from repeated exposure to radiation
• The barium meal will likely taste unpleasant; some institutions have specific flavoring to compensate for the unpleasant taste
• No pain is generally associated with the procedure

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during the Upper GI Series radiology procedure.

How much blood will you lose, during the Procedure?

There is no blood loss involved during an Upper GI Series radiology procedure.

What are the possible Risks and Complications during the Upper GI Series radiology procedure?

• As with any exposure to X-rays, there is a small risk of developing cancer with repeated exposure
• The barium ingested during the GI exam may lead to constipation. This effect can be minimized through drinking appropriate amounts of fluid
• There is a risk to the developing fetus from the procedure, and hence, exposure to X-rays should be avoided during pregnancy
• Children are more sensitive to radiation and X-rays; hence, the exposure should be minimized in children

What Post-Operative Care is needed at the Healthcare Facility after the Upper GI Series radiology procedure?

Generally, there is no post-operative care necessary after an Upper GI Series radiology procedure.

After the Upper GI Series radiology procedure:

What is to be expected after the Upper GI Series radiology procedure?

Generally, no complications or side effects are observed after an Upper GI Series radiology procedure. The individual may feel some gastric distension or mild constipation after the procedure.

When do you need to call your Physician?

The Upper GI Series radiology procedure is an uncomplicated procedure that poses a minimal risk to most individuals.

What Post-Operative Care is needed at Home after the Upper GI Series radiology procedure?

Care should be taken to drink adequate amount of fluids to avoid constipation following the procedure.

How long does it normally take to fully recover, from the Procedure?

Additional recovery time is not necessary following an Upper GI Series radiology procedure.

Additional information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during an Upper GI Series radiology procedure.

When should you expect results from the pathologist regarding tissue taken out during the Procedure?

Since no tissue is removed during the Upper GI Series radiology procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Upper GI Series radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Radiologist or neurologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Upper GI Series procedure is performed.