Decorative image

Barium x-ray

A barium x-ray is a test to look at the outline of any part of your digestive system. 

Barium is a white liquid that shows up clearly on an x-ray. Once it is inside the body, it coats the inside of the oesophagus, stomach or bowel and shows up the outline of the organs on the x-ray.

If there is a tumour, it shows up as an irregular outline extending out from the wall of the affected part of the body.

Barium liquid does not do you any harm and passes through your digestive system so you don't absorb it.

Why you might have it

There are several different types of barium tests. These include: 

  • a barium swallow - this is most often used to look at the inside of the food pipe (oesophagus) or stomach
  • a barium enema - this looks at the large bowel (colon) and back passage (rectum)

Barium swallow

What it is

This is the name for the test that looks at the oesophagus and stomach. This test takes around 20 minutes.

Preparing for your test

You can't eat or drink for a few hours before the test. Your appointment letter will explain when you need to stop eating and drinking beforehand. The exact time depends on the time of your test. If you're not sure about anything contact the x-ray department and ask the radiographer. 

If your diabetic let your radiographer know as you may need to follow specific instructions. Or your appointment may need to change to suit you. 

They will tell you if you need to stop taking any medication before the test.

What to expect

The test takes place in the x-ray department. You'll be given a hospital gown to change into. You also need to remove any jewellery, glasses metal objects or anything that may interfere with the x-ray picture. 

You can bring a friend or relative with you for support, but they're not usually allowed to go into the x-ray room with you.

Once you are in the x-ray room, you drink the barium liquid. This is sometimes fruit flavoured but can taste a bit chalky.

The doctor (radiologist) or radiographer will want to take several pictures of you in different positions while you're swallowing the barium liquid.

You might have an injection of a drug called Buscopan during the test to slow down the movement of your bowel. This movement (called peristalsis) can change the scan and make it more difficult to read. 

After your test

As soon as it's over you can go home. You can also eat and drink normally.

Some people can get a little constipated after the test. To help prevent this drinking plenty of fluids and eat plenty of fruit and vegetables. You'll also have paler or white poo (stools) the first couple of times you go to the toilet.

Some people feel a bit sick after a barium swallow. This should get better as the barium passes through your system.

Barium enema

What it is

You have a barium enema if your doctor wants to look at the inside of your bowel and back passage. This test takes around 40 minutes.

Preparing for your test

The day before the test, you usually need to take some medicine (a laxative) to clear out your bowel. You will have an information leaflet from the hospital to tell you how to take the laxative and what you can eat and drink. You may be told:

  • to drink lots of fluids the day before the test
  • not to eat any solid food on the day before
  • not to eat or drink anything on the day of the test

What to expect

Most people find this test a little undignified and a bit embarrassing, but it should not be too uncomfortable.

You change into a hospital gown before the test. You need to remove any jewellery, metal objects or anything that may interfere with the x-ray picture. 

You might have an injection of a drug called Buscopan into your arm to relax your bowel muscles. 

You lie on the x-ray table on your left side. The radiographer will put a small plastic tube into your back passage (rectum). This may feel uncomfortable but not painful. A small balloon may be inflated to keep the tube there. 

The radiographer moves the x-ray machine into position above you. They then put barium and water through a tube. It's important that you try to hold the liquid in your back passage. You'll have the sensation of being full and wanting to open your bowels. 

The radiographer will ask you to move or they will tilt the table so the barium spreads through the lower bowel. This shows up any lumps or swellings, which can be seen on the x-ray screen. They also put some air into the tube to inflate the bowel so that they get a clearer picture.

Most of the liquid barium drains back into the tube. Once they have taken all the pictures they remove the tube. 

After your test

After the test you might have some mild cramping in your abdomen as the air they put in works its way out. You may also have some diarrhoea and want to use the toilet.

Your first couple of stools (poo) will be white but they will go back to normal after the barium is out of your system. To help wash the barium out of your bowel, and prevent constipation, you should drink plenty of fluids and eat plenty of fruit and vegetables.

Possible risks

Having a barium swallow or barium enema helps doctors find out what may be causing your symptoms but, as with any medical procedure, there are possible risks. Doctors make sure the benefits of doing these tests outweigh any risks.

X-rays and radiation

The amount of radiation you are exposed to during the x-ray is kept to a minimum.

You should not have these tests if you are pregnant.

Injection to relax the stomach or bowel

The injection you have to relax the stomach or bowel may cause temporary blurred vision. If this happens, you should not drive until your eyesight is back to normal.

You might not have this drug if you have glaucoma (increased pressure within the eye) or heart problems. The doctor or radiographer checks this with you when you go for the test.

Barium swallow

With a barium swallow, there is a risk that when drinking it a little bit may go down the wrong way and into your airway. This is very rare.

You can usually cough this up, but you may need physiotherapy to help.

Let the radiographer know if you have any problems swallowing.

Barium enema

During a barium enema, there is a very small risk of making a small tear in the bowel lining. This usually only happens if the bowel is severely inflamed.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment. 

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.

Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

More information

We have more information on tests, treatment and support if you have been diagnosed with cancer.

Last reviewed: 
05 Mar 2019
  • ACR-SPR Practice parameter for the performance of the modified barium swallow
    American College of Radiology, 2017

  • The Royal Marsden Manual of Clinical Nursing Procedures (9th edition)
    L Dougherty and S Lister
    Wiley Blackwell, 2015

  • Dysphagia. Global Guidelines and Cascades
    World Gastroenterology Organisation Global, 2014

  • Guidelines for oesophageal manometry and pH monitoring
    K Bodger and N Trudgill
    BSG Guidelines in Gastroenterology, 2006

  • Videofluoroscopic evaluation of oropharyngeal swallowing function (VFS): The role of speech and language therapists. RCSLT Position Paper 2013
    Royal College of Speech and Language Therapists, 2013

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular risk or cause you are interested in. 

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.