Modified Barium Swallow

WHAT YOU SHOULD KNOW:

• Modified barium (BAR-e-um) swallow, also called MBS, is an x-ray procedure which uses barium to examine problems with swallowing. Liquid barium is a white, chalky contrast material that helps the esophagus (food pipe) show up better on x-ray. The esophagus is the tube that carries food and liquid from the throat to the stomach. With MBS, diseases and other problems that affect swallowing may be diagnosed. These may include cancer (tumor), strictures (narrowing), hernia (defective walls), or diverticuli (pouches in the esophageal wall). Other structures involved in swallowing may also be seen on a video screen while the procedure is taking place. These include the mouth, tongue, throat, and muscles in the upper, middle, or lower esophagus.
  
  
• An MBS may be done on an outpatient basis or while you are confined in the hospital. X-ray pictures are taken while drinking liquids and eating foods. Barium is mixed with liquids and foods, such as puddings or cookies, to show how they pass the esophagus. This may help check what liquids or foods are safe to swallow. MBS may also detect if food or liquids go into the larynx (windpipe) and lungs. With MBS, problems related to swallowing may be diagnosed, and proper treatment may be given.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Modified barium swallow is a common and safe procedure, but may cause side effects. You may have cramping abdominal (stomach) pain, vomiting, or more problems swallowing. The barium may harden if it is not cleared from your body, and block your digestive tract. Barium may also leak out if your esophagus has perforations or may go down your airway (windpipe). This may go into your lungs and cause infections or trouble breathing. If it causes trouble breathing, the heart and brain may not get enough oxygen, which can be life-threatening. Following your caregiver's advice after the procedure may decrease your chances of having any problems.
  
  
• Without this procedure, your exact disease may not be diagnosed and proper treatment not be given. The signs and symptoms you have may continue and worsen. You may have problems eating, digesting food, or moving your bowel that may lead to other serious medical problems. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Gown: A hospital gown is used so that caregivers can easily check and treat you. Caregivers will show you how to put on your gown. When you feel better you may be able to wear your own gown or pajamas.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

During your procedure:

• Once you are in the radiology (x-ray) room, pictures are taken while you are standing and before taking barium. Your caregiver watches the whole procedure on a small video screen and records it.
  
  
• A special caregiver called a speech pathologist gives you barium mixtures to drink. These mixtures may look like milkshakes but taste chalky due to the barium. You may have an urge to vomit (throw up) as the barium passes. You will sit up, stand still, and move your neck and head as pictures are taken. You are asked to keep on breathing, talking, swallowing, and change head positions as you drink the liquids.
  
  
• If you are able to swallow liquids without any problems, swallowing foods are then tested. These foods, such as barium-coated cookies, have different thickness or textures. Pictures are taken to see how food goes down your throat and into the esophagus and stomach. When the procedure is finished, you will drink lots of liquids. This is done to get rid of whatever barium is left inside your body. Additional pictures may be taken after you have passed out as much barium as possible.

After your procedure:

You may lie in bed and rest for a while since the procedure may be tiring. You may need to go back to the bathroom to pass the remaining barium from your body. When caregivers see that you are OK, you may be allowed to go home. If caregivers want you to stay in the hospital, you will be taken back to your hospital room. Ask your caregiver for information on how to take care of yourself after your procedure.

• Bedpan: You may not be able to get out of bed to urinate or to have a bowel movement (BM). If you cannot get out of bed you will use a bedpan. Ask your caregivers if you need help using the bedpan.
  
  
• Eat healthy foods: Choose healthy foods from all the food groups every day. Include whole-grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables. Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources, such as lean beef and chicken, fish, beans, eggs, and nuts. Ask how many servings of fats, oils, and sweets you should have each day, and if you need to be on a special diet.
  
  
• Drinking liquids: Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.
  
  
• Medicines: You may need any of the following:
  
  
  • Enemas or laxatives: Barium may cause constipation (dry, hard stools) and block your colon if it is not passed out of your body. These medicines may be given to help you empty your bowel faster. Ask your caregiver for more information about these medicines.
    
    
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
  
  
• Monitoring: Caregivers may check for your pulses on your arms or wrists. This helps caregivers learn if you have problems with blood flow after your procedure. You may also have the following:
  
  
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.