Esophagram

Esophagram is a test whereby the patient is administered a barium sulfate compound that enables the radiologist to study the function and appearance of the esophagus. A series of x rays of the esophagus is taken after the patient has swallowed the barium. The barium solution coats and outlines the walls of the esophagus. This enables the radiologist to assess the process of swallowing. Hence it is also called barium swallow. An Esophagram is done when the patient complains of pain or difficulty in swallowing. It is also done to assess the reasons for blood stained vomit and when abdominal pain and weight loss occurs or diagnosing cases of Barrett's esophagus. The Esophagram helps the radiologist to detect narrowing, stricture, obstruction or irritation of the esophagus. It helps to study complications such as ulcers, polyps and tumors. It also helps to assess hiatal hernia.

The patient is advised not to eat or drink for 8 to 10 hours prior to the examination. The patient is asked not to smoke or chew gum at least 6 hours prior to the procedure. A patient is given a cup of barium sulfate to swallow. A radiologist watches and evaluates the swallowing process with fluoroscopy. The barium swallowed coats the lining of the esophagus, and x rays are taken to track the pathway to the stomach. The patient is placed in various positions throughout the exam so that structures are optimally demonstrated on the x rays.

The problem is that it can miss small abnormalities in the esophagus such as small erosions and ulcers. This test is not very effective for diagnosing gastro esophageal reflux associated with GERD. Pregnant mothers are advised not to undergo this procedure as the risk of radiation affects the fetus.