X-Ray Studies of the Digestive Tract

ByJonathan Gotfried, MD, Lewis Katz School of Medicine at Temple University
Reviewed/Revised Mar 2023
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X-rays often are used to evaluate digestive problems.

Standard X-Rays

Standard x-rays (plain x-rays) can show some blockages or paralysis of the digestive tract, or abnormal air patterns in the abdominal cavity. They can also show significant enlargement of the liver, kidneys, and spleen.

Standard x-rays do not require any special preparation.

Barium X-Ray Studies of the Digestive Tract

X-ray studies using barium often provide more information than standard x-rays.

X-rays are taken after a person swallows barium in a flavored liquid mixture or as barium-coated food. The barium looks white on x-rays and outlines the digestive tract, showing the contours and lining of the esophagus (the hollow tube that leads from the throat to the stomach), stomach, and small intestine. Barium may collect in abnormal areas, showing ulcers, tumors, blockages, and erosions and enlarged, dilated esophageal veins.

Fluoroscopy

X-rays may be taken at intervals to determine where the barium is. In a continuous x-ray technique called fluoroscopy, the barium is observed as it moves through the digestive tract. With this technique, doctors can see how the esophagus and stomach function, determine whether their contractions are normal, and tell whether food is getting blocked.

Barium enema

Barium also can be given in an enema to outline the lower part of the large intestine.

Barium enema x-rays can show polyps, tumors, or other structural abnormalities. This procedure may cause crampy pain or slight to moderate discomfort.

Barium taken by mouth or as an enema is eventually passed in the stool, making the stool chalky white. Because barium can cause significant constipation, the doctor may give a gentle laxative to speed up the elimination of barium.

Although barium studies are still sometimes done to evaluate digestive problems, endoscopy and alternative imaging tests such as CT enterography and CT colonography have largely replaced barium studies because of their superior image quality.

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