What is the procedure for a barium meal examination?

From the Guidelines

The procedure for a barium meal examination involves ingesting a barium sulfate suspension, followed by fluoroscopy imaging to visualize the upper gastrointestinal tract 1.

Key Steps:

• The patient is instructed to ingest a suspension of barium sulfate, typically 200-300 mL of a 100% weight/volume (w/v) solution, 30 minutes to 1 hour prior to the procedure.
• The barium sulfate suspension may be flavored and mixed with a thickening agent to improve palatability.
• An effervescent agent such as Simethicone (80-160 mg) may be administered to reduce foam and gas in the gastrointestinal tract, and Metoclopramide (10-20 mg) may be given 10-15 minutes prior to the procedure to enhance gastric emptying and reduce symptoms of nausea and vomiting.
• The patient is then positioned on a fluoroscopy table and imaging is performed over a period of 30-60 minutes to visualize the upper gastrointestinal tract, including the esophagus, stomach, pylorus, and duodenum 1.

Important Considerations:

• The barium meal examination can be performed as a multiphasic examination, including upright double-contrast views, prone single-contrast views, and mucosal-relief views with either density of barium suspension 1.
• The double-contrast phase optimizes the ability to detect inflammatory or neoplastic diseases, whereas the single-contrast phase optimizes the ability to detect hiatal hernias and lower esophageal rings or strictures 1.

From the FDA Drug Label

The volume and concentration of LIQUID POLIBAR PLUS® to be administered will depend on the degree and extent of contrast required in the area(s) under examination and on the equipment and technique employed. Patient Preparation for Colon Examinations In order to achieve optimum results, the colon must be cleansed prior to the use of a barium enema. This is usually accomplished by placing the patient on a low fat, low residue diet, combined with the use of laxatives and/or cathartics. A cleansing enema may also be used unless contraindicated.

The procedure for a barium meal examination is not directly described in the provided text. However, for a barium enema, the patient preparation involves:

• Placing the patient on a low fat, low residue diet
• Using laxatives and/or cathartics
• Possibly using a cleansing enema unless contraindicated 2. For a barium meal examination, the administration of barium sulfate depends on the:
• Degree and extent of contrast required
• Equipment and technique employed 2.

From the Research

Procedure for Barium Meal Examination

The procedure for a barium meal examination involves the use of barium sulphate suspension to enhance image contrast of the gastrointestinal tracts 3. Here are the key points to consider:

• A biphasic contrast study is generally advocated as the best current barium examination for the upper GI tract, employing a medium-density barium suspension and glucagon 4.
• The examination can be performed with a single-contrast or double-contrast approach, depending on the patient's ability to cooperate 4.
• The use of a barium meal can safely, promptly, and routinely prove or disprove small bowel obstruction, especially in cases where plain films of the abdomen are equivocal 5.
• Characteristic roentgenographic findings with use of barium meal in intestinal obstruction include normal to rather rapid transit time to the point of obstruction, homogenous dilution of barium in dilated proximal loops, and inhomogenous, scattered, and fragmented collections of barium in the distal, collapsed loops 5.
• Radiation doses for barium meal examinations can vary widely, and diagnostic reference levels (DRLs) can be established to provide a framework for comparison and corrective action 6.
• Trained radiographers can perform and interpret barium meal examinations to a high standard, with accuracy, sensitivity, and specificity rates of 98.9%, 98%, and 98.9%, respectively 7.

Key Considerations

• The examination should be performed with attention to radiation dose levels, which can be minimized with the use of modern fluoroscopy equipment and optimized techniques 3, 6, 7.
• The choice of barium suspension and examination technique should be tailored to the individual patient's needs and medical history 4, 5.
• The use of a barium meal examination should be guided by clinical judgment and the results of other diagnostic tests, such as endoscopy and plain films of the abdomen 4, 5.