Dysphagia barium swallow

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2], Hamid Qazi, MD, BSc [3]

Overview

Among patients with dysphagia, barium study is considered the preferred method for evaluating patients as it allows assessment of function of the upper gastrointestinal tract and morphology.

Barium Swallow

Modified barium swallow study

Conducted by a speech pathologist in conjunction with a radiologist:^[1]^[2]^[3]^[4]
Different consistencies of liquid and food mixed with barium sulfate are fed to the patient by spoon, cup or syringe, and x-rayed using videofluoroscopy
Penetration aspiration scale describes the disordered physiology of a person’s swallow using the numbers 1-8

Findings

Barium swallow study helps in diagnosing the underling etiology of patients presenting with dysphagia such as:

Dysphagia in patients with
- History of surgery for laryngeal or esophageal cancer
- History of radiation or irritating injury
Achalasia
Zenker’s diverticulum, a barium swallow should be performed first instead of endoscopy to prevent any perforation.
Achalasia
Stricture

Barium swallow appearance of DES
Source:By Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)

Case courtesy of Dr Mario Umana, Radiopaedia.org, rID: 38071

Source: Barium swallow showing esophageal cancer. Case courtesy of Dr Andrew Dixon, <a href=”https://radiopaedia.org/“>Radiopaedia.org</a>. From the case <a href=”https://radiopaedia.org/cases/9907“>rID: 9907</a>

References

↑ Chen, Yu Men; Ott, David J.; Gelfand, David W.; Munitz, H. Alexander (1985). “Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques”. Gastrointestinal Radiology. 10 (1): 311–316. doi:10.1007/BF01893119. ISSN 0364-2356.
↑ Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. “Dysphagia, 11,” 93-98.
↑ Logemann, Jeri A.; Pauloski, Barbara Roa; Rademaker, Alfred; Cook, Barbara; Graner, Darlene; Milianti, Frank; Beery, Quinter; Stein, David; Bowman, Julia; Lazarus, Cathy; Heiser, Mary Anne; Baker, Theresa (1992). “Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients”. Dysphagia. 7 (4): 179–186. doi:10.1007/BF02493468. ISSN 0179-051X.
↑ Levine, Marc S.; Rubesin, Stephen E. (2017). “History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus”. Dysphagia. 32 (1): 55–72. doi:10.1007/s00455-016-9774-y. ISSN 0179-051X.

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[ChenOtt1985-1] Chen, Yu Men; Ott, David J.; Gelfand, David W.; Munitz, H. Alexander (1985). “Multiphasic examination of the esophagogastric region for strictures, rings, and hiatal hernia: Evaluation of the individual techniques”. Gastrointestinal Radiology. 10 (1): 311–316. doi:10.1007/BF01893119. ISSN 0364-2356.

[2] Rosenbek, J. C., Robbins J. A., Roecker, E. B., Coyle, J. L., & Wood, J. L. (1996). A penetration aspiration scale. “Dysphagia, 11,” 93-98.

[LogemannPauloski1992-3] Logemann, Jeri A.; Pauloski, Barbara Roa; Rademaker, Alfred; Cook, Barbara; Graner, Darlene; Milianti, Frank; Beery, Quinter; Stein, David; Bowman, Julia; Lazarus, Cathy; Heiser, Mary Anne; Baker, Theresa (1992). “Impact of the diagnostic procedure on outcome measures of swallowing rehabilitation in head and neck cancer patients”. Dysphagia. 7 (4): 179–186. doi:10.1007/BF02493468. ISSN 0179-051X.

[LevineRubesin2017-4] Levine, Marc S.; Rubesin, Stephen E. (2017). “History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus”. Dysphagia. 32 (1): 55–72. doi:10.1007/s00455-016-9774-y. ISSN 0179-051X.

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