An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine.

See also: Barium enema

An upper GI and small bowel series is done in a medical office or hospital radiology department.

You may be given an injection of a medication that will temporarily slow bowel movement, so structures can be more easily seen on the x-rays.

Before the x-rays are taken, you must drink 16 - 20 ounces of a millkshake-like drink that contains a substance called barium. An x-ray method called fluroscopy tracks how the barium moves through your esophagus, stomach, and small intestine. Pictures are taken with you in a variety of positions. You may be sitting or standing.

The test usually takes around 3 hours. However, in some cases, it may take up to 6 hours to complete.

A GI series may include this test or a barium enema.

You may be told to change your diet for 2 or 3 days before the test. Usually, you can not eat for period of time before the test.

Be sure to ask your health care provider if there are any medication restrictions. Generally, you can continue medications you take by mouth. Never make any changes in your medications without first talking to your health care provider.

You will be asked to remove all jewelry on your neck, chest, or abdomen before the test.

The x-ray may cause mild bloating but usually causes no discomfort. The barium milkshake feels chalky as you drink it.

This test is done to determine if you have a structural or functional problem in the esophagus, stomach, or small intestine.

The esophagus, stomach, and small intestine are normal in size, shape, and movement.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

• In the esophagus, abnormal results may mean:
  • Achalasia
  • Benign esophageal stricture (narrowing)
  • Diverticula
  • Esophageal cancer
  • Hiatal hernia
  • Ulcers
• In the stomach, abnormal results may mean:
  • Benign gastric ulcer
  • Gastric cancer
  • Gastritis
  • Polyps (a tumor that is usually non-cancerous and grows on the mucous membrane)
  • Pyloric stenosis (narrowing)
• In the small intestines, the test may reveal:
  • Malabsorption syndrome
  • Swelling and irritation of the small intestines
  • Tumors

• Alcoholic neuropathy
• Annular pancreas
• Cystic fibrosis
• Cytomegalovirus (CMV) gastroenteritis/colitis
• Duodenal ulcer
• Gastroesophageal reflux disease
• Gastroparesis
• Intestinal obstruction
• Lower esophageal ring
• Ovarian cancer
• Primary or idiopathic intestinal pseudo-obstruction

There is low radiation exposure, which carries a very small risk of cancer. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most experts feel that the risk is low compared with the benefits.

Pregnant women should usually not have this test. Children are more sensitive to the risks of x-rays.

Barium may cause constipation. Consult your health care provider if the barium has not passed through your system by 2 or 3 days after the exam.

The upper GI series should be done after other x-ray procedures, because the barium that remains in the body may block details in other imaging tests.

Caroline DF, Kendzierski RM. The stomach. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008: chap 31.

Pickhardt PJ. Diagnostic imaging procedures in gastroenterology. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 135.