An Upper Gastrointestinal (GI) series is a specialized diagnostic imaging procedure used to examine the esophagus, the stomach, and the duodenum (the first segment of the small intestine). The test uses real-time X-ray technology and a swallowed contrast material to map the internal structures of these organs. By making the internal lining visible, the Upper GI series assists physicians in identifying various functional or structural abnormalities that may be causing digestive distress.
Purpose and Medical Applications
A physician often orders an Upper GI series to investigate persistent, unexplained digestive symptoms. These symptoms frequently include ongoing nausea, vomiting, abdominal pain, or difficulty swallowing (dysphagia). The test is particularly useful for assessing structural issues not easily seen on standard X-rays.
The procedure helps diagnose conditions such as ulcers, which appear as irregularities in the lining. It can also identify signs of Gastroesophageal Reflux Disease (GERD) by observing the backflow of contrast material from the stomach into the esophagus. Structural problems like hiatal hernias, strictures, and blockages are detectable. The test also assists in identifying abnormal growths, such as tumors or polyps, and assessing motility disorders where the tract muscles do not function properly.
Preparing for the Upper GI Test
Preparation for an Upper GI test ensures the upper digestive tract is completely empty, allowing the contrast material to coat the lining effectively. Patients are instructed to fast for eight to twelve hours before the procedure. This requirement includes avoiding all food, liquids, chewing gum, and smoking, as these stimulate digestion and interfere with image clarity.
Patients should discuss all current medications with their physician, as some may need adjustment, particularly those affecting stomach acid or motility. It is important to inform the technologist about any possibility of pregnancy, as X-ray procedures involve ionizing radiation. On arrival, patients must remove all metal objects, such as jewelry, eyeglasses, and dentures, to prevent image distortion.
The Upper GI Series Procedure
The Upper GI series relies on Barium sulfate, a chalky white compound that absorbs X-rays. Since Barium is not absorbed by the body, it safely coats the inner surface of the digestive organs, making their contours visible on X-ray images. The procedure begins with the patient standing or lying on an examination table beneath a specialized X-ray machine.
The patient drinks the liquid Barium, which often has a slightly chalky taste. As it is swallowed, the radiologist uses fluoroscopy, a technique that produces a real-time, moving X-ray image similar to a video. Fluoroscopy allows the physician to watch the Barium pass through the esophagus, stomach, and duodenum, observing both the structure and movement of the organs.
For enhanced detail, a double-contrast study may be used, employing both Barium and air. The patient may swallow effervescent granules, which create gas when mixed with stomach contents. This gas expands the stomach, allowing the thin coat of Barium to highlight fine surface details of the mucosal lining. This technique improves the detection of subtle lesions or inflammation.
During the examination, the radiologist asks the patient to change positions, such as lying on their back, side, or stomach, and the table may be tilted. This movement ensures the Barium fully coats the inner surface of the organs. The radiologist may also apply gentle pressure to the abdomen to help spread the Barium and better visualize the internal folds. The procedure typically ranges from 30 minutes to an hour, though it can take longer if the Barium moves slowly.
Interpreting and Following Up on Results
After imaging is complete, the radiologist analyzes the static and moving images captured during fluoroscopy. The radiologist looks for specific patterns, such as irregular contours suggesting ulcers or tumors, areas of persistent narrowing (strictures), or abnormal movement signifying a motility issue. Findings related to the function of the lower esophageal sphincter, which can point to reflux, are also noted.
The radiologist compiles a detailed report of the findings, which is sent to the physician who requested the test. Results are typically available within one to three days, though this timeline can vary.
Following the procedure, patients are encouraged to drink plenty of fluids to flush the Barium out of the digestive system and prevent constipation. The Barium will cause stools to appear white or light-colored for a few days until it is fully excreted. The patient then meets with their primary physician to discuss the report and determine any necessary treatment or further diagnostic testing.