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An esophagram is a medical imaging study of the esophagus, using X-rays and a radiopaque contrast agent, usually barium. This test is also known as a barium swallow or upper gastrointestinal series. A doctor may request an esophagram to evaluate a patient's swallowing ability, look for causes of bleeding in the esophagus, and check on other gastrointestinal health issues. Usually, the test can be given on an outpatient basis, and the risks associated with this procedure are very low.
In an esophagram, the patient swallows a mix of barium sulfate and water. The mixture may be flavored to make it more palatable, but generally, the experience is unpleasant. A series of X-rays are taken as the barium moves through the patient's esophagus and upper GI tract. These X-rays are studied with the goal of getting to the bottom of a medical issue like painful swallowing. The barium will pass through the patient's body and be excreted along with other waste products.
The X-ray exposure involved with an esophagram is relatively low and is considered a calculated risk for the patient. The value of the diagnostic testing is deemed important enough to expose the patient to a small amount of radiation. If the patient needs additional medical imaging involving X-rays and other radiation, the history of a recent esophagram will be considered when making decisions about how to proceed. Generally, patients are not at risk of damage from nuclear imaging because their exposures are low and the imaging studies are infrequent.
As an alternative to an esophagram, a doctor may consider an endoscopy, where a camera is inserted into the esophagus and used to study its structure and general physical condition. This can sometimes identify issues that will not show up on X-ray and can eliminate the need for an expensive and invasive exploratory surgery to examine the esophagus. This test is performed with the patient under sedation for comfort and can also be done on an outpatient basis.
When an esophagram is recommended, the patient can ask why the test is being requested and if there are any alternatives available. The doctor should be able to provide detailed information about the test and can discuss potential avenues of treatment that may be recommended once the results are in hand. It can take several days for test results on an esophagram, depending on whether a radiologist is available to read the images immediately or if they need to be sent out.
When I went to the GI specialist, I asked the nurse about the advantages of having an esophagram rather than a endoscopy. She told me that a esophagram is more accurate when the doctor is trying to tell if the esophagus is narrowing.
It is less expensive and easier than doing an endoscopy. Endoscopy may miss clues about the narrowness of the esophagus and other problem features because it is not stretched enough to see clearly.
I've had both an esophagram and an endoscopy. The esophagram was quite unpleasant - especially swallowing that white chalky barium. I was having some trouble swallowing, so the doctor stretched the opening between the throat and the esophagus.
Some years later, I went in because of heartburn. The doctor decided to do an endoscopy. There was no discomfort here - you are sedated as a little camera takes a tour of your esophagus. There is just a little discomfort for a few hours after the procedure.
The doctor found a little damage from stomach acid and this time the opening from the esophagus to the stomach would open at the wrong time, letting stomach acid into the esophagus.
Medicine helped the situation a lot.