Upper GI Series Procedure
There are two main ways of doing UGI. The old-fashioned, conventional, single contrast study is still being done by radiologists. Most residents in radiology today are trained in the newer air contrast study, which has become the more widely used of the two procedures.
You may still run into a more senior radiologist who has considerable experience in the conventional UGIs and prefers to do that study unless the air contrast study is specifically requested. The old-fashioned UGI is about as pleasant an experience as a person can have in radiology. The barium is not delicious, but it is tolerable. Generally, you will be face-to-face with the radiologist, unless the test is done by remote control with the radiologist sitting behind a leaded glass window. There will be a technologist in the room assisting the physician.
Most often the test will be started in the upright position. You will drink the barium and the radiologist will watch it go down for a variable period. Every now and then, the radiologist will stop looking and take a picture to look at later.
Generally, you will be able to watch the entire procedure on a black-and-white television monitor. Of course, you will not be able to decipher the image. Feel free to ask the radiologist to point things out to you.
The table will be lowered with you either on it or off it, and the radiologist will study the same organ in a few other positions. Generally, you will start off with your right side up against the table drinking barium from a straw. At some point, you will be asked to lie on your back so that the air in the stomach and duodenum can rise to the top and displace the barium. The end result will be that barium lines the walls and air fills the tubes, allowing the radiologist to get the best possible view to evaluate these structures.You may be placed in any variety of positions that allow better viewing of the structures that the radiologist needs to see.
Air Contrast UGI
The air contrast UGI offers a definite improvement over the conventional UGI, which is accomplished by distending the stomach. In addition to the barium, you will be asked to swallow a material that radiologists call "fizzies." This white "crystal-like" substance makes gas when it is combined with liquid. For the radiologist, the pictures obtained from the air contrast UGI are much better and more effective than the conventional study. The test is usually slightly more prolonged, and you may have to assume more positions so that the radiologist can get more pictures. Remember not to burp; keep the gas where it needs to be.
After the radiologist leaves, the technologist may take up to four or five additional x-rays. Some departments no longer obtain additional films, but most still do. Then you are done. Remember to drink plenty of liquids for a couple of days.
Constipation is the biggest side effect, which can often be avoided by drinking plenty of liquids. Some departments give patients stool-softening medication, which may be helpful. Remember that the barium is inert and passes through the bowel almost unchanged; so it may be visible upon elimination.