74249 Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through

Name of the Procedure:

• Common Name: Upper GI Series with Air Contrast and Small Bowel Follow-Through
• Medical Term: Radiological Examination, Gastrointestinal Tract, Upper, Air Contrast, with Specific High-Density Barium, Effervescent Agent, with or without Glucagon; with Small Intestine Follow-Through

Summary

An upper GI series with air contrast and small bowel follow-through is an imaging procedure that uses X-rays to visualize the upper part of the gastrointestinal tract, including the stomach and small intestine. This involves drinking a special barium solution and using air to create a clearer image of the GI tract.

Purpose

• Medical Condition: Investigates issues like unexplained abdominal pain, difficulty swallowing, or gastrointestinal bleeding.
• Goals: To diagnose problems such as ulcers, tumors, inflammation, blockages, or abnormal motility in the upper GI tract and small intestine.

Indications

• Symptoms: Abdominal pain, heartburn, unexplained vomiting, difficulty swallowing, and gastrointestinal bleeding.
• Criteria: Suitable for patients with suspected GI tract disorders, unexplained symptoms, or abnormal previous imaging results.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for several hours before the procedure. It's often recommended to avoid smoking and certain medications that can interfere with the test.
• Diagnostic Tests: Blood tests or preliminary imaging studies might be needed.

Procedure Description

1. Initial Preparation: Patient changes into a hospital gown.
2. Ingestion: Patient drinks a barium solution that coats the lining of the GI tract.
3. Effervescent Agent: An agent is ingested to produce gas and improve image clarity.
4. Imaging: X-rays are taken as the patient is positioned in various ways to capture different angles.
5. Glucagon Option: Sometimes, glucagon is administered to relax the GI muscles.
6. Follow-Through: Continuous imaging follows the barium through the small intestine.
   • Tools: X-ray machine, specific high-density barium solution, effervescent agent.
   • Anesthesia/Sedation: Not typically required.

Duration

The procedure usually takes about 1-2 hours, depending on the motility of the GI tract.

Setting

Typically performed in a radiology department within a hospital or an outpatient imaging clinic.

Personnel

• Radiologist
• Radiology Technologist
• Nurses (if necessary)

Risks and Complications

• Common Risks: Mild discomfort, bloating, nausea.
• Rare Risks: Allergic reaction to barium, bowel obstruction, perforation.
• Management: Monitoring and supportive care.

Benefits

• Expected Benefits: Clear images that can lead to accurate diagnosis and effective treatment plans.
• Timing: Diagnostic information is usually available shortly after the procedure.

Recovery

• Post-Procedure Care: Encouraged to drink plenty of fluids to help expel the barium.
• Recovery Time: Typically short, with patients resuming normal activities the same day.
• Follow-Up: Instructions include watching for side effects and possible follow-up imaging based on initial results.

Alternatives

• Other Options: Endoscopy, CT scan, MRI.
• Pros and Cons: Endoscopy is more invasive but provides direct visualization; CT and MRI are alternative imaging forms but may not be as detailed for some GI issues.

Patient Experience

• During: Patients might feel fullness, bloating, or slight discomfort.
• After: Some may experience changes in bowel habits or minor constipation. Pain management usually involves simple over-the-counter medications or discomfort relief through fluids and a high-fiber diet.