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. This then shows the outline of the organs on the x-ray and any abnormal areas. 

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)

You have your barium test in the x-ray or radiology department in the hospital. A radiologist or radiographer usually does the test and looks after you during the test.

We have information on having a barium swallow and a barium enema. These tests are now less common than they used to be. You may have a:

• CT scan or MRI instead of a barium swallow
• colonoscopy or CT scan instead of a barium enema

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 will have an appointment letter from the hospital with information about what to do before the test and on the day of the 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. The exact time depends on the time of your test. If you're not sure about anything, contact the staff in the x-ray department. 

If you're diabetic, let your radiographer know. You may need to follow specific instructions. Or your appointment may need to change to suit you. They will also tell you if you need to stop taking any medication before the test.

It's important to let the staff know beforehand if you are pregnant or think you are pregnant.

Having a barium swallow

Before you start, your radiographer will tell you what happens during and after your test. This is a good time to ask any questions you might have. You can bring a friend or relative with you for support. They can stay with you until you go into the x-ray room.

They give you 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. 

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 radiologist or radiographer will want to take several pictures of you in different positions. They do this while you swallow the barium liquid.

You might have an injection to relax your tummy muscles during the test. This helps the movement of the barium liquid. You may not be able to have this injection if you have eye problems or heart problems. Let the radiology staff know beforehand if you have one of these conditions.   

After your test

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

Some people can have constipation after the test. To help prevent this, drink plenty of fluids and eat plenty of fruit and vegetables. You might also feel bloated. You will 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. It helps to have someone to travel home and be with you afterwards in case you do feel sick.

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

You will have an appointment letter with information about what to do before the test and on the day of the test.

The day before the test, you usually need to take a laxative to clear out your bowel. Your appointment leaflet will explain 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

You should contact the x-ray department if changing what you eat and drink beforehand may be a problem. For example, if you are diabetic.

After taking the laxatives, you might need to use the toilet often and very suddenly, and you may have tummy cramps. It's best to stay at home for a few hours after taking laxatives so that you are near a toilet.

You must let the x-ray staff know if you are pregnant or think you might be pregnant. 

During the test, you may have to move from your front to your back a few times. Call the number on the appointment letter if this may be a problem.

Having a barium enema

The person doing the test will explain what will happen. You can ask any questions you may have.

The procedure shouldn’t be too uncomfortable. But most people find this test a little undignified and embarrassing. Try not to worry, the staff looking after you understand how you may feel. They will put you at ease and have done this procedure many times before.

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 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. This may feel uncomfortable, but not painful.

The radiographer moves the x-ray machine into position above you. They then put barium and water through the plastic 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 into different positions or they will tilt the table so the barium spreads through the lower bowel. This shows up any lumps or swellings that they can see 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 soft or loose poo and need to use the toilet a few times before you leave. You might want to stay in the department for a little while after the procedure until you feel comfortable leaving the hospital.

Your first couple of times you have a poo, it will be white. It 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

An x-ray uses small amounts of radiation to take pictures of the inside of your body. The amount of radiation you receive from an x-ray is small and doesn't make you feel unwell.

The risk of radiation causing any problems in the future is very small. The benefits of finding out what is wrong outweigh any risk there may be from radiation.

pregnancy

You should not have these tests if you are pregnant. Contact the x-ray department before your test if you are pregnant or think you are pregnant.

Allergic reaction

There is a small risk of having an allergic reaction to the barium, but this is rare. Tell your radiographer immediately if you have difficulty breathing, develop a rash, start sweating, or feel weak. 

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.

After the injection, you might also have

• a faster heartbeat
• a dry mouth
• problem peeing

Contact your doctor or the x-ray department if you have any of these symptoms. 

Possible risks after a 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.

Possible risks after a 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, but it may take longer. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

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

More information

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