Your doctor has requested that you have a barium swallow. We hope the following information will answer some of the questions you may have about this procedure.

What is a barium swallow?

It is an examination of the oesophagus (food pipe) and the stomach. These areas of your body cannot normally be seen on X-ray images.

The procedure uses a type of X-ray, called fluoroscopy, to view images in real time.

The images are taken as you swallow a white liquid (called barium) down into your stomach. The procedure is carried out by a specialist radiographer.

How do I prepare for a barium swallow?

Please do not eat or drink for a minimum of 4 hours before your appointment time. If you need to, you can take small sips of water or clear fluid. Diabetic patients to ensure blood sugars are maintained.

Continue to take your normal medication unless otherwise instructed; however please inform us if you are allergic to anything.

If you are diabetic please ensure your blood sugars are maintained.

The procedure uses X-rays and the amount of radiation used is very low, however if you think you may be pregnant please inform the Imaging department before attending the appointment. The telephone number for the Imaging department can be found on the appointment letter.

On the day of the procedure

• You will arrive at Gate 18 and a member of the Imaging team will take you through to the fluoroscopy waiting room.
• The specialist radiographer will discuss the procedure with you. You will be given an opportunity to ask questions. If you are happy to proceed you will be asked to change into a hospital gown.
• You will be asked to stand next to the X-ray machine and you will then be asked to take mouthfuls of the liquid barium and to swallow it as the X-ray images are taken. The specialist radiographer will take a number of X-rays to watch the barium pass through your oesophagus and into your stomach.
• You may be asked to stand in different positions so the oesophagus and stomach can be viewed from several angles.
• The examination is usually complete within 20 minutes, but may take longer. You may need to wait for a few minutes afterwards so we can make sure we have all the necessary information.

After the examination

• There will still be some barium retained in the bowel and your stools will appear whitish in colour for a couple of days.
• Barium can occasionally cause constipation, so we recommend that you drink plenty of fluids afterwards.
• You can eat and drink normally after the examination. Eating a high fibre diet like bran or wholemeal bread can help, but the main thing is to drink plenty of fluids.

What are the risks associated with a barium swallow?

Barium swallows are generally regarded as a very safe test and problems rarely occur. The barium liquid is not absorbed by the body as it only coats the walls of the oesophagus, stomach and bowel.

• If you have difficulty in swallowing there is a risk of aspiration (breathing in) the barium. Please inform the Imaging department before your appointment if you are known to aspirate when you drink.
• Fluoroscopy involves the use of X-rays; however with modern equipment the risk is very low (NRPB 2014).

How will I get the results?

You will not get an indication of the result at the time of the examination, as analysis of the images will take place after you have left the department.

The specialist radiographer and a radiologist (specialist imaging doctor) will report on review your examination at the earliest opportunity. A written report will follow and this will be sent to the doctor who requested the examination. Allow 7-10 days for the doctor to receive the report.

Finally we hope this information is helpful. If you have any questions either before or after the procedure, the staff in the Imaging department will be happy to answer them.

The telephone number for the X-ray department can be found on the appointment letter. 

References / other resources

Public Health England (2014) “Guidance – Exposure to ionising radiation from medical imaging: safety advice”

Guy’s and St Thomas’ NHS Foundation Trust (2019) “Having a barium swallow”

BSGAR (2011) British Society of GI and Abdominal Radiology Barium Swallow Patient Information Leaflet

How to contact us

Telephone: 0300 555 0103

If you or the individual you are caring for need support reading this information please ask a member of staff for advice.

If you’re an overseas visitor, you may need to pay for your treatment or you could face fraud or bribery
charges, so please contact the overseas office:

• Tel: 0117 414 3764
• Email: overseas.patients@nbt.nhs.uk