Barium

Hormone/ Element

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No Fasting Required

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Heavy metal test for barium exposure.

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Barium Test - Comprehensive Medical Information Guide

Why is it done?
- Test Purpose: Barium studies are radiographic imaging tests that use barium sulfate contrast medium to visualize the gastrointestinal (GI) tract. Barium is a radiopaque substance that appears white on X-ray images, allowing physicians to see the structure and function of the esophagus, stomach, small intestine, and colon.
- Primary Indications: Evaluation of chronic abdominal pain, persistent vomiting, or suspected GI obstruction; Detection of ulcers, strictures, polyps, or malignancies; Assessment of swallowing disorders (dysphagia) or esophageal motility disorders; Investigation of chronic diarrhea or constipation; Evaluation of suspected diverticular disease; Detection of gastric or intestinal bleeding sources; Monitoring of inflammatory bowel disease (Crohn's disease or ulcerative colitis)
- Common Types: Upper GI (esophageal/gastric) series; Lower GI (colon/barium enema) series; Small bowel follow-through; Video fluoroscopic swallow study
- Typical Timing: Performed as outpatient procedure; Takes 30 minutes to 2 hours depending on type; Follow-up imaging may be recommended at 24 hours for small bowel studies
Normal Range
- Normal Findings: Barium studies are qualitative (descriptive) rather than quantitative, so there are no numeric reference ranges. Normal results indicate absence of abnormalities.
- Normal Upper GI Series Findings: Smooth esophageal walls with normal peristaltic contractions; Patent esophagus without strictures or diverticula; Normal gastric shape and size; Intact stomach lining without ulcers or masses; Normal pyloric sphincter function; Normal duodenum without obstructions
- Normal Lower GI Series (Barium Enema) Findings: Smooth mucosal pattern of the colon; Normal haustral pattern without narrowing; Patent cecum and appendiceal orifice; No filling defects (polyps or masses); No evidence of diverticula; Normal ileocecal valve; No strictures or areas of stenosis
- Normal Small Bowel Follow-Through: Smooth mucosa without ulceration; Normal caliber bowel loops; Normal peristaltic activity; Progressive barium transit through duodenum to jejunum to ileum; Barium reaches ileocecal valve within 3-4 hours; No areas of obstruction, narrowing, or dilation
- Result Interpretation: Negative/Normal = No pathological findings detected; Positive/Abnormal = Presence of demonstrated abnormalities requiring further evaluation or clinical correlation
Interpretation
- Abnormal Findings - Upper GI: Gastric or duodenal ulcers (crater-like defects with surrounding barium pooling); Esophageal strictures (narrowed areas); Hiatal hernia (portion of stomach protruding through diaphragm); Gastric malignancy (irregular narrowing or wall rigidity); Achalasia (dilated esophagus with bird's beak appearance at gastroesophageal junction); Gastric outlet obstruction (narrowing at pylorus)
- Abnormal Findings - Lower GI: Colonic polyps (filling defects); Colorectal cancer (apple-core narrowing or shouldering); Diverticular disease (outpouchings of colon wall); Inflammatory bowel disease (mucosal ulceration, shortened colon); Bowel obstruction (abrupt cutoff of barium); Colonic strictures; Ischemic colitis (thumbprinting appearance)
- Abnormal Findings - Small Bowel: Strictures (narrowed segments); Dilated loops (suggesting obstruction or malabsorption); Ulceration (seen in Crohn's disease); Malignant lesions; Adhesions; Intussusception; Delayed transit indicating dysmotility
- Factors Affecting Results: Inadequate bowel preparation (stool obscuring view); Retained barium from previous studies; Patient motion during imaging; Excessive patient anxiety affecting motility; Recent barium ingestion; Medications affecting GI motility (anticholinergics, opioids); Bowel spasm (may mimic pathology); Recent endoscopy or biopsy
- Clinical Significance: Barium studies provide excellent visualization of mucosal detail and GI tract anatomy; Sensitive for detecting ulcers, strictures, and masses; Can evaluate functional abnormalities (motility disorders); Less sensitive than endoscopy for small lesions; Cannot obtain tissue samples for biopsy; Useful for evaluating surgical changes or anatomic variants
Associated Organs
- Primary Organ Systems: Gastrointestinal tract (esophagus, stomach, small intestine, colon); Pharynx and oropharynx (in swallow studies); Associated structures including diaphragm, pyloric sphincter, ileocecal valve
- Commonly Associated Conditions: Peptic ulcer disease; Gastroesophageal reflux disease (GERD); Achalasia; Barrett's esophagus; Crohn's disease; Ulcerative colitis; Celiac disease; Irritable bowel syndrome; Intestinal obstruction; Diverticular disease; Colorectal polyps and cancer; Gastric cancer; Viral or bacterial gastroenteritis; Food allergy/intolerance
- Diagnostic Value: Excellent for detecting structural abnormalities; Assesses mucosal surface characteristics; Evaluates functional motility disorders; Identifies anatomic variants; Can guide need for endoscopy or further imaging
- Potential Complications of Abnormal Results: Bleeding from severe ulcers; Bowel perforation from malignancy or severe inflammation; Obstruction requiring surgical intervention; Malnutrition from malabsorption; Sepsis from perforated viscus; Chronic pain and disability from strictures; Increased cancer risk with certain conditions
Follow-up Tests
- Tests Following Abnormal Upper GI Findings: Esophagogastroduodenoscopy (EGD) for tissue biopsy; CT imaging for cancer staging; H. pylori testing for peptic ulcer disease; Esophageal manometry for motility disorders; pH monitoring for GERD; Endoscopic ultrasound for submucosal lesions
- Tests Following Abnormal Lower GI Findings: Colonoscopy for polyp removal or tissue sampling; CT colonography for additional evaluation; CT imaging for cancer staging; Inflammatory markers (ESR, CRP) for IBD; Fecal calprotectin for IBD assessment; MR enterography for small bowel Crohn's disease
- Tests Following Abnormal Small Bowel Findings: Video capsule endoscopy for mucosal detail; CT/MR enterography for 3D visualization; Enteroscopy for tissue sampling; Tissue transglutaminase antibodies for celiac disease; CT imaging for obstruction assessment
- Monitoring for Known Conditions: IBD patients: Repeat barium studies annually or per clinical indication; Stricture patients: Follow-up imaging after intervention; Cancer patients: Surveillance per oncology protocols; Post-surgical patients: Follow-up studies at 3-6 months as indicated
- Complementary Imaging: CT abdomen/pelvis for comprehensive evaluation; MRI for soft tissue detail; Ultrasound for initial imaging in some conditions; Abdominal X-ray for acute obstruction
Fasting Required?
- Fasting Requirement: YES - Fasting is required for all barium studies
- Upper GI Series Fasting Instructions: NPO (nothing by mouth) for 6-8 hours before procedure; No food, beverages, or gum; No smoking; Small sips of water allowed 2 hours before if absolutely necessary (confirm with facility); Continue essential medications with minimal water
- Lower GI Series Preparation: Bowel cleansing is essential; Day before: Clear liquid diet only (broth, juice, gelatin); Take prescribed laxatives or bowel preparation solution (GoLYTELY, MiraLAX, or similar); Day of procedure: NPO for 2-4 hours; May include enema or suppository on morning of test; Follow facility-specific preparation instructions exactly
- Medications to Avoid: Anticholinergic medications (can affect motility); Opioids (avoid if possible); Antacids containing aluminum or bismuth (interfere with imaging); Iron supplements (can obscure image); Bismuth-containing products; Inform radiologist of all medications before procedure
- Additional Patient Preparation: Wear loose, comfortable clothing; Remove all metal objects (jewelry, buttons); Provide pregnancy status (absolute contraindication); Disclose recent barium studies (may need delay); Inform of allergies (especially shellfish/iodine); Disclose diabetes, renal disease, or bowel obstruction; Arrange transportation if sedation used; Plan for residual barium (may affect stool for several days); Drink extra fluids after procedure

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