Doctors use barium swallow tests to evaluate dysphagia, or difficulty swallowing. This test helps healthcare providers see how the esophagus—the tube leading from the mouth to the stomach—functions during swallowing. It can be used to diagnose many causes of dysphagia. Most people tolerate the procedure well, but it’s best to know ahead of time what to expect with barium swallow test prep and side effects, and the typical timeline for the procedure and test results.
You (or your child, if your child is the one having the test done) will need to abstain from food and drink for a few hours before the test. How long you’ll have to go without food and water depends on age and the preferences of the healthcare provider performing the test. Generally, adults are asked to stop eating between 4 to 8 hours prior to the procedure. Some facilities allow adults to continue drinking clear liquids until 2 hours before the test.
Here are the typical requirements for children, but it varies by the doctor and testing facility:
Children ages 2 years and older should stop eating solid food 6 hours before the barium swallow; they can have a liquid diet (which includes broth and jello) until approximately 4 hours before the procedure.
Children ages 7 to 24 months should not eat in the 4-hour window before the exam.
Infants up to age 6 months can breastfeed or have a bottle as late as 3 hours before the scheduled appointment.
When you arrive for the test, you’ll be asked to remove all jewelry and change into a hospital gown. (Pants can remain on.) Then, you or your child will be asked to drink 1 to 2 cups of barium, a chalky substance that will allow your physician to clearly visualize the swallowing process. The barium is usually flavored—strawberry is a popular flavor—and similar in consistency to a shake.
Sometimes, patients are asked to eat barium ‘cookies’ or drink a thinner barium liquid later (after the initial shake-like barium); doing so allows healthcare providers to see how the patient’s mouth, throat (pharynx) and esophagus handle foods of various consistencies. A barium swallow test involving different textures and consistencies is a modified barium swallow. Some children’s hospitals may use the term cookie swallow.
During the procedure, the patient lies on an X-ray table that can move from horizontal to vertical. If your child is having the test, you can be in the room—unless you are pregnant. The radiation in the X-rays used during the study can be damaging to a developing fetus. Another caregiver (or a healthcare provider) will remain with your child.
As the patient is drinking the barium, a technologist will take a series of X-ray photographs or X-ray video. A barium swallow study takes approximately 30 minutes, including prep time. This part of the test is an esophagram (radiography of the esophagus). Another name for the barium swallow and esophagram is videofluoroscopic swallowing study (VFSS).
Most people tolerate the procedure easily. The most likely side effect is constipation.
You (or your child) can resume normal activities after the study. Drink extra fluids for approximately 24 hours; doing so will help the body flush out the barium and help prevent constipation. It is normal for bowel movements to appear lighter in color (or even white) after a barium study.
Your physician will usually receive the results of the swallow study within 24 hours of the exam. Ask your physician when—and how—you'll be informed of the results.
