An esophagram is a kind of X-ray that takes video images of your esophagus in action. It’s also called a barium swallow test. During the procedure, you swallow a barium contrast solution. The fluoroscopic X-ray beam visualizes your throat and esophagus while you swallow.
An esophagram (sometimes called an esophagogram or esophagography) is an X-ray exam of your esophagus. This type of X-ray exam doesn’t just take still pictures. The esophagram is a fluoroscopic X-ray exam, which means it takes X-rays as a live video. This way, healthcare providers can see your esophagus in action while you swallow. Your healthcare provider might suggest an esophagram to investigate problems in your esophagus, such as swallowing problems or reflux.
Yes, the barium swallow test is another name for an esophagram. The nickname comes from the contrast agent that makes your esophagus show up in X-rays. Barium sulfate is used in many types of radiology exams to coat your insides and help them show up better on images. For the esophagram, you’ll swallow a solution with barium in it. The barium will coat your esophagus as it travels down to your stomach, and your technician will be able to watch it happen.
The esophagram visualizes your esophagus (food pipe) and what happens inside when you swallow. Your healthcare provider might want to see what’s going wrong with your ability to swallow if you’re having difficulties, or they might want to look for evidence of disease on the inside of your esophagus.
Some things they might look for include:
An esophagram can help identify a variety of esophageal disorders, including:
Your healthcare provider might take an esophagram as part of a general upper gastrointestinal (GI) series of X-rays. The upper GI series takes fluoroscopic X-rays of your entire upper gastrointestinal tract, including your esophagus, stomach and duodenum (the first part of your small intestine). Healthcare providers recommend comprehensive GI X-ray exams when you have mysterious symptoms and they need to screen for a wide range of possible causes. If they already suspect your problem is in your esophagus, they may recommend an isolated esophagram to look for the problem there.
An esophagram is a type of fluoroscopy or fluoroscopic X-ray exam. Instead of taking isolated X-ray snapshots, a fluoroscopy procedure passes a continuous X-ray beam through your body to display a continuous video image on a screen. This allows healthcare providers to watch your body mechanics in action — in this case, the actions of your upper digestive tract after you swallow. To make these mechanisms show up on the fluoroscopy, you’ll swallow a special solution containing a contrast material called barium. Barium is chalky and white and shows up great in black and white images, but it can be unpleasant to drink.
An upper endoscopy exam is more invasive than an esophagram, but it can show the upper GI tract in more detail if needed. An endoscopy involves passing a tiny lighted video camera on a tube down your throat, through your esophagus and into your stomach and duodenum. You may need to be medicated for this exam to help you relax and numb your throat. Most of the time, your healthcare provider will recommend an esophagram first, but they may need to follow up with an endoscopy in some cases. Some patients, such as pregnant people, may require an endoscopy instead to avoid the radiation exposure associated with X-ray exams.
A note from Cleveland Clinic
X-ray technology is the oldest and most frequently used type of medical imaging, with a long tradition of maintaining safe levels of radiation exposure. Healthcare providers take care to use the lowest radiation dose possible and minimize stray radiation by carefully controlling X-ray beams. Only the body part under examination should be exposed. While frequent small doses of radiation could add up to greater risk, side effects from a typical stand-alone X-ray exam are rare. The risks of anesthesia and other more invasive procedures are greater. In most cases, the benefits of radiology far outweigh the risks.
Last reviewed by a Cleveland Clinic medical professional on 04/13/2022.
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