Fluoroscopy
Fluoroscopy is a type of X-ray that allows part of the body to be studied in
motion and recorded on a video monitor. This type of X-ray is used to examine
the gastrointestinal (GI) tract--which includes the esophagus, stomach, small
intestine, large intestine (colon) and rectum--so that your physician can detect
abnormalities in the size, shape, position or functioning of these organs.
Fluoroscopic gastrointestinal examinations may be performed in a physicians
office, a commercial X-ray facility or a hospital.
These tests are usually called either "upper GI" or "lower GI" tests, depending on the organs that are to be studied.
Upper GI test
The upper GI test is used to examine the esophagus, stomach and part of the
small intestine. For this test, the patient drinks a contrast solution that
contains barium. The barium solution is sweetened and
flavored, but does taste chalky. There will be both thick and thin mixtures
of the barium solution you'll be asked to drink (usually totaling 12 to 14
ounces). The doctor or assistant will tell you when to take sips of the
solution.
As the barium passes through the digestive tract, it provides an outline of
the swallowing process as well as the esophagus, stomach and part of the small
intestine. The fluoroscope is held over the part of the body being examined and
transmits continuous images to the video monitor.
This test is used to diagnose hiatal hernias, ulcers,
tumors, diverticulitis, esophageal varices, obstruction, narrowing, or enteritis
(inflammation of the small intestine lining). It may also be used to determine the causes
of swallowing problems, reflux, abdominal pain, diarrhea, unexplained vomiting or weight loss
or bleeding.
Types of Upper GI Tests
Barium swallow (esophagography)
X-ray examination of the esophagus. Approximate time: 1 hour.
Upper GI series
X-ray examination of the stomach. Approximate time: 1 to 1-1/2 hours.
Small bowel series
X-ray examination of the small intestine (small bowel). Approximate time: 2 to 4 hours.
Lower GI test
The lower GI test is used to examine the large intestine and the rectum. For
this test, barium is introduced gradually into the colon through a tube inserted
into the rectum. As the barium passes through the lower intestine, it provides
an outline of the intestinal wall. The fluoroscope is held over the part of the
body being examined and transmits continuous images to the video monitor.
This test is used to detect polyps, tumors, diverticulitis, gastroenteritis, irritable colon,
ulcerative colitis or other causes of abdominal pain, or blood, mucus or pus in the stool.
Types of Lower GI Tests
Air contrast barium enema (also called double contrast barium enema)
X-ray examination of the large intestine (colon). Barium and air are introduced gradually into the colon by a rectal tube. Approximate time: 1-1/2 to 2 hours.
Barium enema
X-ray examination of the large intestine (colon). Barium is introduced
gradually into the colon by a rectal tube. Approximate time: 1 to 1-1/2 hours.
Before the upper and lower GI tests
Please be aware that correct preparation is very important for the upper and
lower GI tests to be performed properly. The radiologist will tell you what you
need to do to prepare for your specific GI examination.
Preparation usually includes making dietary changes (such as following a
low-fiber diet for 2 to 3 days before the test), not smoking for 12 to 24 hours
before the test, not taking any medications for 24 hours before the test and not
eating anything for 12 hours before the test. Additional preparation for the
lower GI test usually includes taking an enema or laxative the night before the
test. Please follow the pretest directions carefully and ask questions if you do
not understand them.
All examinations are performed and interpreted by registered and licensed
technologists and board-certified radiologists.
During the test
You may be given a mild sedative. You will be positioned on a tilting X-ray
table by the technologist and will be secured with straps. For an upper GI test,
the table usually starts in a vertical position, with the patient standing. For
a lower GI test, the table usually starts in a horizontal position, with the
patient lying on his or her side. The table will be tilted at various angles
during the test to help spread the barium solution throughout the body so
different views can be seen on the fluoroscope. During the test, the
technologist may put slight pressure on your abdomen to get a clearer image on
the fluoroscope.
Although the barium solution given in an upper GI test is unpleasant tasting,
there is no pain and little discomfort during the procedure. The lower GI test
may cause some discomfort, including cramps and a strong urge to have a bowel
movement.
After the barium enema is administered in a lower GI test and a few X-rays
are taken, you will be helped to the bathroom (or be given a bedpan) and you
will be asked to move your bowels to expel as much of the barium as possible.
Then you will go back to the X-ray examination room where more X-rays will taken
of the barium solution that remains on the lining of the intestine. In some
cases, air will be injected slowly into the colon (air contrast barium enema) to
provide further contrast on the X-rays in order to detect abnormalities.
Are the tests safe?
There is virtually no risk with the upper and lower GI tests, unless they are
repeated several times within a few months’ time, when radiation then becomes
a risk. Although radiation exposure is minimal, it is greater than for standard
still X-rays. Fluoroscopic gastrointestinal examinations are performed by
registered and licensed technologists and board-certified radiologists who
carefully limit the X-ray to the specific area to be diagnosed so that
surrounding parts of the body are not exposed. A lead apron may be worn during
the procedure to protect the parts of the body that are not being studied.
- The risk of infection is very low with both the upper and lower GI tests.
- The additional risk associated with the
lower GI test, although very low, is the risk of a tear in the intestinal
wall. Should this occur, surgery may be necessary.
- If you have an existing blockage or tear
in the intestinal wall, the upper and lower GI tests should not be performed.
- If you are pregnant or think you might be
pregnant, you should not have these tests unless absolutely medically
necessary. Talk to your doctor about other tests that can be more safely
performed to diagnose your problem during pregnancy.
After the upper or lower GI test
- Generally you can resume your usual activities and normal diet immediately.
- Drink plenty of fluids.
- The barium given during the test may cause
constipation, so a laxative or enema might be prescribed after the test.
- The barium enema given during the lower GI test may cause you to feel week or dizzy.
- It is normal for your stool to have a white or light color for up to three days after the test.
When to call your doctor
After the test, call your doctor if you have:
- A temperature of 101 degrees Fahrenheit or
higher. This could be a sign of infection and should be treated right away.
- A marked change in bowel habits (such as
no bowel movement in 2 to 3 days after the test. Remember it is normal for
your stool to have a white or light color for up to three days after the test.
- Worsening of pain
- Any unusual rectal drainage
- Other symptoms that cause concern
- Questions about the test or the results
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/14/2005...#7144
