Barium Meal

In a barium meal test, X-ray images are

taken of the stomach and the beginning of
duodenum (the beginning of small
intestine, the passageway that takes food
away from the stomach). A barium meal
test is often performed straight after a
barium swallow test

Methods
Double contrast:
The method of choice to demonstrate mucosal pattern.

Single contrast uses :

Children since it usually is not necessary to
demonstrate mucosal pattern
Very ill adults to demonstrate gross pathology only.

Basic Anatomy

Barium Meal indications

Dyspepsia.
Weight loss,
Upper abdominal mass.
Gastrointestinal haemorrhage,
Partial obstruction

Barium Meal Contraindications

Complete large bowel obstruction.

BARIUM MEAL
procedure
Contrast medium
125ml Barium sulphate suspension 250% w/v

Patient Preparation
Nil by mouth for 6 hrs prior to examination. Smoking
should be avoided on the day of the examination since it
increases gastric motility

Preliminary films
None

Technique
A gas producing agent is swallowed.
The patient then drinks the barium whilst lying on his
left side, this prevents the barium from reaching the
duodenum too quickly and so obscuring the greater
curve.
The patient then lies supine and slightly on his right
side and trendelenberg tilted to bring the barium up
against the gastro oesophageal junction, this
manoeuvre is screened to check for reflux and the
patient is asked to cough to encourage reflux,
Spot films are taken if reflux occurs.

An I.V. injection of a smooth muscle relaxant is

given.
The patient is then asked to roll onto his right
side then completely over to fully coat the
stomach wall to finish in RAO position .

Position

Demonstrates

Supine RAO

Antrum and greater curve

Supine

Antrum and body

Supine LAO

Lesser curve

Supine Left Lateral, (head up

45 degree)

Fundus

Prone

Duodenal loop

Prone, RAO, Supine,

LAO

Duodenal Cap series

Erect

Fundus

Erect (RAO, LAO)

Duodenal Cap series

Erect RAO Swallow

Oesophagus

Position
Supine RAO
Supine
Supine LAO
Supine Left Lateral,
(head up 45 degree)
Prone
Prone, RAO, Supine,
LAO ,
Erect RAO, LAO
Erect

Demonstrates
Antrum and greater curve
Antrum and body
Lesser curve
Fundus

Duodenal loop
Duodenal Cap series
Fundus

 From prone position, the patient lies on the

left side first the supine then to the right side
to prevent barium flooding into the
duodenum

Aftercare
The patient should be warned his bowel
motions will be white for a few days, some
centres advise a mild laxative for 48 hrs to
encourage the passage of barium and reduce
the possibility of impaction.

Complications
Leakage of barium from unsuspected
perforation,
Aspiration,
Obstruction,
Barium appendicitis.
Side effects of any other drugs used.