For people who have difficulty swallowing or suspect that they have dysphagia, a visit to a doctor is necessary to obtain a correct diagnosis. Swallowing problems are identified by physical examination as well as through various barium swallow tests.
A barium swallow study is essentially an X-ray study of the upper gastrointestinal tract, particularly the pharynx (back of mouth and throat) and the esophagus (the hollow tube of muscle extending from below the tongue to the stomach). These bodily structures cannot be observed well via X-ray on their own; these structures do not contain substances that would show up on X-ray film. Therefore, a material called barium is used to create a clearer picture.
Barium, specifically barium sulfate, is a chemical compound that absorbs X-rays. Those areas show up white on X-ray film. This dry, white, chalky powder is mixed with water to make a thick, milkshake-like drink. When a patient ingests the liquid, it coats the inside walls of the pharynx and esophagus so that these areas and swallowing motion are visible via X-ray.
In another type of test, patients may be asked to consume barium-coated foods of different consistencies. This test provides an image of the foods as they travel down the throat and into the stomach instead of focusing on the walls of the esophagus. Barium-coated food exams can identify blockages that the liquid barium solution may not indicate.
Barium swallow tests can aid in identifying structural abnormalities of the upper GI tract as well as motion difficulties as the patient swallows.
Barium studies can also be used to diagnose gastroesophageal reflux disease (GERD).
There are a few specific situations in which a barium study may be risky. For one, if a patient has been exposed to radiation recently, they should inform the doctor of past scans and radiation treatments. Risks associated with radiation are generally related to the cumulative number of X-ray examinations or treatments over a long period.
For women who are pregnant, notify your doctor before participating in a barium swallow study. Patients who are allergic to medication, contrast dyes, iodine, or latex should tell the doctor about these.
Once dysphagia is identified, there are several courses of action the patient can take to assist in proper food intake: