Upper GI with Small Bowel Series

What is an upper GI with small bowel series?

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

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

How an upper GI (with small bowl series) works

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.

Your child will swallow 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

An upper GI series may take 20 minutes to 1 hour. A radiologist and radiological technologist perform the test.

Keep in mind that 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.

Upper GI series safety

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. Talk with your child’s care team if you have concerns.

How to prepare your child for the test

• Your child must have an empty stomach for the exam, so they cannot eat or drink for several hours before the test.
• The care team will give you instructions to follow. They depend on the patient’s age. Follow the instructions exactly.

Make sure your child: 

• 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. Your child will probably wear a hospital gown during the test.

Before the test

• Depending on the hospital, you may need to consult with your insurance company to find out how much it will pay for the procedure.
  
• Tell the medical team about:
  • Any medications the patient takes, including over-the-counter ones.
  • Allergies, especially to contrast liquid. (barium)
  • If your child 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.
• You will stay in a waiting area until it is time for the procedure. Bring activities just in case the waiting period is long.
• You can usually stay with your during the test unless you are pregnant. Plan for another adult to accompany your child, if needed.
• Siblings are usually not allowed in the X-ray room. Plan arrangements for siblings.

During an upper GI exam

• A radiology staff member will talk with you about why your child needs an upper GI series and will explain the procedure.
• The staff member will help your child onto the X-ray table.
• Your child will drink a barium shake, which will make their 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 care team 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 care team will help your child move around in different positions so the machine can take pictures at different angles.

The test does not hurt. The X-ray machine (fluoro tower) will not touch your child.

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

The test can take several hours depending on how quickly the barium moves through the system. Talk to the care team about what your child can do during the waiting period.

After the test

Give your child extra liquids because the barium may cause constipation.

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

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