This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on March 2, 2022.
A barium swallow is a noninvasive X-ray technique commonly used to examine the throat and esophagus for swallowing difficulties and physical abnormalities, helping to detect problems such as gastroesophageal reflux disease (GERD), ulcers or polyps. It’s also a valuable tool to look for cancer in the upper digestive tract (from the mouth to the first part of the small intestine).
Doctors may use it specifically to diagnose esophageal (food pipe) cancer and stomach cancer, as well as head and neck cancers, including:
In addition to cancer, results from a barium swallow may detect:
The procedure uses X-ray images to follow the progress of a liquid containing barium sulfate, a metallic element from the earth, through the upper digestive tract. This group of X-rays is called an upper GI series.
To facilitate an upper GI series, you may be asked to drink a fizzy liquid to distend your stomach with gas to separate the walls of your stomach.
A barium swallow may be used to focus on the throat and esophagus or to examine all of the upper gastrointestinal tract.
If your symptoms include dysphagia, or problems swallowing, your doctor may order a video version of the test to determine the cause and look for signs of esophageal, laryngeal or hypopharyngeal cancers. An instrument called a fluoroscope helps track the movement of the barium, which is displayed on a video monitor. In this instance, the test is called an esophagram. Other names for it are modified barium swallow and videofluoroscopy.
The test also may be used if your doctor suspects cancer has opened a fistula, or hole, between the esophagus and trachea (windpipe). This serious complication may result in swallowed food and liquid passing into the lungs, where it may cause pneumonia.
Though a barium swallow may be used to check for stomach cancer, physicians more often introduce an endoscope through the mouth or nose down the esophagus to do a visual exam of the stomach’s lining and take tissue samples (biopsies). An upper GI series often times provides information complementary to endoscopy.
You shouldn’t undergo a barium swallow if you’ve had recent gastric or esophageal surgery, or trauma to your digestive tract unless specifically ordered by your surgeon. You should also skip the procedure if it’s possible you’re pregnant.
Before the procedure:
Side effects of barium sulfate include:
Nausea and vomiting within a half-hour after swallowing barium are the more prevalent side effects. But overly adverse reactions aren’t common, so if you have strong or persistent side effects after the test, tell your care team. Let them know immediately if you have any of these potentially serious side effects:
The upper GI tract—including the stomach, throat and esophagus—typically has a smooth lining, and fluid and structures move in a certain way. A normal result means the size, shape, physical movement and appearance of the area show no irregularities.
Your care team may discuss all of the results of your barium swallow test with you, as well as the need for possible follow-up.
A barium swallow alone is often not enough to make a final diagnosis. Other tests, such as esophagoscopy or other endoscopic or other imaging procedures, may need to be done, so that your care team may view the area in greater detail and examine a tissue biopsy.