Upper Gastrointestinal Series (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 (also known as the duodenum). 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 duodenum.

An upper GI examination helps evaluate digestive function and can detect:

  • ulcers
  • tumors
  • inflammation of the esophagus, stomach and duodenum
  • hiatal hernias
  • scarring
  • blockages
  • abnormalities of the muscular wall of GI tract

The procedure is also 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)

Barium Swallow (Esophagram)

These tests require two different densities of barium drinks and effervescent granules, taken with a small amount of water. The radiodense barium allows the examination of the function and the anatomical lining of the esophagus, stomach and proximal small intestine, also known as the duodenum. A barium swallow study is a variant of the UGI in which the patient’s swallowing mechanism, pharynx, and esophagus are the focus of the study. A small bowel follow-through is a continuation of a UGI whereby the entire small bowel is examined.

Small Bowel Follow-Through

In all the studies above, the patient swallows the barium, which then lines or “paints” the walls of the structures desired. The gas crystals are used to create air and help distend the structures to allow more precise images.