Pediatric X-Ray – Upper GI
Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the esophagus, stomach and first part of the small intestine. Images are produced using a special form of x-ray called fluoroscopy and an orally ingested contrast material such as barium.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and part of the small intestine.
In addition to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further improve the images. This procedure is called an air-contrast or double-contrast upper GI.
The procedure is used to help diagnose the cause of symptoms such as:
- difficulty swallowing
- chest and abdominal pain
- reflux (a backward flow of partially digested food and digestive juices)
- unexplained vomiting
- severe indigestion
- blood in the stool (indicating internal GI bleeding)
Exam Preparation
Your physician will give you detailed instructions on how to prepare your child for an upper GI. You should inform your physician of any medications being taken and if there are any allergies, especially to iodinated contrast materials. Also inform the doctor about recent illnesses or other medical conditions.
To ensure the best possible image quality, your child’s stomach must be empty of food. Therefore, your doctor will ask you not to give your child anything to eat or drink (including any medications taken by mouth, especially antacids) and to refrain from chewing gum generally 2 – 6 hours prior to the exam depending on the age of the child.
Your child may be asked to wear a gown during the exam, and may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
The Exam
A radiologic technologist and a radiologist guide the patient through the upper GI series.
As the patient drinks the liquid barium, which resembles a light-colored milkshake, the radiologist will watch the barium pass through the patient's digestive tract on a fluoroscope, a device that projects radiographic images in a movie-like sequence onto a monitor. The exam table will be positioned at different angles and the patient's abdomen may be compressed to help spread the barium. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review.
Children usually drink barium contrast material without any objection. If a child will not drink the contrast, the radiologist may need to pass a small tube into the stomach to complete the examination.
Older children will be asked to hold very still and may be asked to hold their breath for a few seconds while the x-ray pictures are taken.
When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained.
This exam is usually completed within 20 minutes.
After the Exam
After the examination, your child can resume a regular diet and take orally administered medications unless instructed otherwise by your doctor.
The barium may color your child’s stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the test can also help. If you are unable to have a bowel movement or if your bowel habits undergo any significant changes following the exam, you should contact your physician.
A radiologist will analyze the images and send a report to the referring physician, who will discuss the results with you.
