74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study

Name of the Procedure:

Radiologic Examination, Upper Gastrointestinal Tract with Single-Contrast Study (Barium Swallow)

Summary

A radiologic examination of the upper gastrointestinal (GI) tract, involving the use of a barium-based contrast material to visualize the esophagus, stomach, and the first part of the small intestine using X-rays.

Purpose

This procedure helps diagnose problems in the upper GI tract such as ulcers, tumors, inflammation, blockages, and abnormal structures. It aims to provide detailed images that help in identifying the cause of symptoms like pain, acid reflux, or difficulty swallowing.

Indications

• Persistent upper abdominal pain
• Difficulty swallowing (dysphagia)
• Chronic acid reflux or heartburn
• Unexplained vomiting
• Suspected ulcers, tumors, or infections
• Follow-up for previously diagnosed conditions

Preparation

• Patients are typically required to fast for at least 8 hours before the procedure.
• Certain medications might need to be paused or adjusted.
• Initial diagnostic tests, such as blood work, may be necessary to rule out other conditions.

Procedure Description

1. The patient is asked to change into a hospital gown and remove any jewelry or metal objects.
2. Initial “scout” X-rays of the abdomen are taken without any contrast to provide a baseline image.
3. The patient drinks a barium solution, which coats the lining of the upper GI tract.
4. Multiple X-rays are taken in various positions to ensure thorough imaging of the organs.
5. Delayed images may be captured to observe how barium moves through the GI tract over time.
6. No sedation or anesthesia is typically required; the procedure is done while the patient is awake.

Duration

The entire procedure typically lasts about 30 to 60 minutes.

Setting

The procedure is performed in a hospital or outpatient clinic with radiologic imaging facilities.

Personnel

• Radiologist (a doctor specialized in imaging)
• Radiologic technologist
• Nursing staff may be present for patient support

Risks and Complications

• Mild side effects like nausea or constipation due to barium.
• Rare risk of barium impaction if there is a blockage.
• Exposure to low levels of radiation, which carries minimal risk.
• Allergic reaction to the contrast material, although very rare.

Benefits

• Provides clear, detailed images of the upper GI tract.
• Helps in accurate diagnosis and treatment planning.
• Non-invasive and relatively quick with minimal discomfort.

Recovery

• Patients can usually resume normal activities immediately after the procedure.
• Drinking plenty of fluids post-procedure is advised to help expel the barium.
• Follow-up with the doctor to discuss results.

Alternatives

• Upper GI endoscopy: Involves using a flexible tube with a camera but is more invasive.
• CT scan with contrast: Provides detailed cross-sectional images but involves higher radiation exposure.
• MRI: Effective but more expensive and less available.

Patient Experience

• The barium solution may taste chalky and can feel heavy in the stomach.
• Minimal discomfort is expected during the X-ray process.
• Post-procedure, some patients might experience minor bloating or constipation.
• Pain management is generally not needed, but hydration and mild laxatives may be recommended if constipation occurs.