Upper GI with Small Bowel Series

An upper GI (gastrointestinal tract) series allows the radiology team to view the upper GI tract. It includes the esophagus, stomach, and upper part of the small intestine (duodenum).

What is an upper GI with small bowel series?

An upper GI series with small bowel series includes the esophagus, stomach, and the entire small intestine.

How does an upper GI (with small bowl series) work?

This procedure uses a technology called fluoroscopy to look inside the body and see internal organs in motion. It is like a “live” x-ray that is viewed on a computer screen. The patient swallows a contrast liquid that contains a substance called barium. This milky  white liquid helps the esophagus, stomach, and intestines appear more clearly. The radiology team watches as the barium travels down the gastrointestinal tract. 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.

Patients may have an upper GI series to help find the cause of certain symptoms:

• Abdominal pain
• Gastrointestinal bleeding
• Persistent vomiting
• Lack of weight gain

How long does the test take?

An upper GI series may take 20 minutes to 1 hour.

An upper GI with small bowel series may take 2-6 hours or perhaps longer. The length of time depends on how long it takes for the contrast liquid to make its way through the small intestine.

Who performs an upper GI series?

A radiologist and radiological technologist perform the test.

Is an upper GI series safe?

An upper GI series is a type of X-ray. It uses a small amount of ionizing radiation to produce images. The medical benefits far outweigh the small amount of radiation exposure. Parents should discuss any concerns with the medical team.

What must patients do to prepare?

• Patients must have an empty stomach for the exam, so they cannot eat or drink for several hours before the test.
• The staff will give the family instructions to follow. The instructions depend on the patient’s age. Families should follow the instructions exactly, or the test will be rescheduled.

How can parents help the patient prepare?

Parents should make sure the patient:

• Understands the test and what will happen. Child life specialists can help with explanations.
• Wears loose, comfortable clothing that is easy to change in and out of. The patient will probably wear a hospital gown.

What details should be taken care of before the test?

• Depending on the hospital, parents may need to consult with their insurance company to find out how much it will pay for the procedure.
• Parents should tell the medical team about:
  • Any medications the patient takes, including over-the-counter ones.
  • Allergies, especially to contrast liquid. (barium)
  • If the patient is or could be pregnant.
• Allow plenty of time to get to the center. It is important to arrive at the appointment on time, even a few minutes early to allow time for check-in.
• The parent and patient will stay in a waiting area until it is time for the procedure. Bring activities just in case the waiting period is long.
• A parent can usually stay with the patient during the test unless the parent is pregnant. Parents should make arrangements for another adult to accompany the patient, if needed.
• Siblings are usually not allowed in the X-ray room. Parents should make childcare arrangements for siblings.

What happens during an upper GI exam?

• A radiology staff member will talk with the family about why the patient needs an upper GI series and will explain the procedure.
• The staff member will help the patient onto the X-ray table.
• The patient will drink a barium shake, which will make her esophagus, stomach and intestines visible on the X-ray screen. The barium has an unpleasant, chalky taste. Some centers add flavoring to the shake.
• The staff member will move the X-ray machine, also known as “fluoro tower,” over the patient.
• The radiologist will take several X-rays as the barium flows through the gastrointestinal tract.
• The staff will help the patient move around in different positions so the machine can take pictures at different angles.

What will the patient feel?

The test does not hurt. The X-ray machine (fluoro tower) does not touch the patient.

The contrast liquid may not taste pleasant. The family can ask about adding flavoring.

The test can take several hours depending on how quickly the barium moves through the system. Parents should talk to the staff about what the patient can do during the waiting period.

What will the patient experience after the test?

Parents should give the patient extra liquids because the barium may cause constipation.

Stools may appear white or gray for a day or two due to the barium.

How will families find out the results?

The radiologist will interpret the results and send a report to the doctor who ordered the test. A member of the medical team will share results at the next appointment.