Barium meal is one of an x-ray that allows doctors to examine the channels of the patient's mouth to the stomach and first part of the large intestine (the duodenum). Even though barium swallow is used to view the esophagus, but the path is equal to the passage of barium meal to view the colon.
X-ray usually move continuously through the intestines, such as esophagus, stomach, and intestines. All these structures will not be seen by the practice of x-ray images. However, if the routes intestines is entered or passed by the Barium, a white liquid that does not allow x-rays through it, the image structure of the gastrointestinal tract can be seen and identified.
If the inspection involves the structure of the stomach, is called barium meal examination. If the examination involves the esophagus, it is called a barium swallow and sometimes it is called a barium meal.
Contrast media for this procedure is composed of barium salts. Salt will prominently display the internal parts. These reviews are conducted to investigate the presence of complications such as dyspepsia (indigestion), sudden weight loss, bleeding in the organs of the upper gastrointestinal tract, or anemia (iron deficiency), and gastrointestinal reflux.
Anatomical parts involved:
1. stomach
2. part of the intestine (bowel.
Indications for barium enema:
1. dyspepsia- Dyspepsia is pain or discomfort in the upper abdomen or upper part of stomach. It has also been defined in many kinds of ways by a certain of professional team.
2. weight loss-decrease of weight in kilogram
3. stomach ache-feeling pain of stomach.
4. gastrointestinal haemorrhage-bleeding of gastrointestinal tract.
5. obstruction of the passage of the stomach-a blockage in stomach causing the passage to be stuck.
Types of contrast media and drugs used:
1 E-Z HD 250% W / V 135ml
2. Carbex Granules (doubles contrast technique)
3. gastrografin that contains barium (a liquid solution)
The equipment used:
1. (OF set) oesophageal feeding set
2. With the ability to rapidly Fluroscopy film 10 frames / second
3. syringe
4. fluoroscopy table with slanting 90/20
5. special equipment 'feeding' may be needed. (cups and spoons)
6. feeding tube size 5 / 6
7. injection equipment
8. lignocaine gel 2%
9. microphone (plaster)
10. sterile gloves
11. fluoroscopy table above together with pieces of lead.
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Patient preparation
Is a priority of radiographers to explain to the patient, preparation steps before the day of examination. First, patients are asked to prepare by fasting for at least 8 to 9 hours before an x-ray. This is to ensure that patients on an empty stomach without any food or bolus before inspection. It also can prevent from misleading results. Regardless, make sure the patient's medical history was examined, and identified, is intended to ensure that no new patients undergoing abdominal surgery. Quantity of food intake in low-and high fiber are recommended to avoid and minimize excessive gas caused by the process of digestion. Some radiographers believes that smoking and chewing gum can stimulate the secretion of gastric fluids and saliva. Therefore, patients were also asked to stop smoking and chewing gum to prevent excess fluid from gathering in the stomach and the thicker barium sulfate.
If the patient has diabetes or cannot have fast (on the advice of a doctor), the procedure for such patients should be undertaken immediately. Ensure that hospital staff are aware of this prior to the examination of the patient's progress. This is because, radiographers can provide a specific instructions to the patient.
After the explanation given by the radiographers, he must ensure that patients understand the procedures to be undertaken, in addition, patients are required to sign an agreement indicating the patient understands and agrees to undergo medical examination to be conducted.
If the patient is female, ask about their menstrual cycle. It seeks to examine whether or not they are pregnant. Make sure the patient's medical history if there are known allergies. This is to avoid the effects of anaphylactic shock. It also facilitates the doctors and radiographers to look for contrast media that are appropriate to the patient's condition. These measures should be taken seriously on those who are allergic to iodine.
Barium meal procedure
Barium meal procedure takes about 15 to 20 minutes. So radiographers shall direct the patient to change their clothes to the hospital gown provided in the dressing room. Once the patient has finished changing clothes, the patient is instructed to drink a white liquid containing barium(with flavor inside). Typically, a liquid containing barium is a mixture of fruit flavors. Radiographers must put the correct amount of fluid and given to patients by one or two feeds, in the same time. After that, take the patient to a radiation room for the next procedure. Then, radiographers should help position the patient on the table, and opposite to x-ray tube (upright or supine position (AP)). After that, the patient will be asked to swallow a teaspoon of liquid . Liquid barium will be dissolved in the stomach of patients and it produces carbon dioxide (such as vitamins drug foaming when dissolved in water). When there is liquid and gas in the stomach, The gas spread out into the stomach and duodenum and also thrust the barium into the coat that lining of the stomach and duodenum. This makes the X-ray image much clearer, as it is the shape and form of the lining of the stomach and duodenum which need to be seen most visibly on the radiographic pictures. it will affect particularly the stomach wall and eventually published a photo on the x-ray graph(patient may be asked to hold breath at a certain times during the procedures). After that, patients will also be given an injection in the muscles to help muscle a rest and helps prevent the stomach from moving during the inspections conducted. Finally, the image of the intestine and the stomach will be displayed on the TV screen. This process is called Fluoroscopy. Next, the picture will be taken and stored or recorded.
What should patients do after completion of the examination?
Patients will be allowed to go home, but a warning should be given to them. Make sure they know that their stool white for several days due to the reaction of barium. They are also advised to drink water frequently to avoid precipitation of barium in the stomach. Intake of fluids also needed to expel the barium by giving a carthatic or laxative. In addition, for those who received the injection of Buscopan, is advised to take a break while waiting for the medication is gone. When the patient was at home, they also suggested taking the vegetables, fruits that contain high fiber. This will help restore bowel movements and prevent constipation.
What are the risks of this examination?
A barium meal is generally a safe test, but like any procedure, there are occasionally complications. Your doctor should be advised of problems so you can be treated right away. You as a patient should be aware of adverse effects and risks that may be encountered during the procedure and after the procedure. Upon completion of the examination, the patient will usually be exposed to x-ray radiation and it depends on the use of barium meal, the amount of radiation exposure is similar to receiving radiation from the natural environment of 8 to 16 months.
If a pregnant patient
The pregnant women are advised not to take an x-ray. This is because, x-ray radiation will impair the baby during pregnancy. If you are pregnant, should be notified prior to the radiographers so that action can be taken perfectly without any problems.
Side effects
Allergic reactions or anaphylaxis can occur in people who are allergic to drinking barium. Constipation can also occur if the patient is allergic to the medicine. You can accidentally get barium in the trachea (windpipe). The medical term for this is the aspiration. So, notify your physician to report any of the case regarding to the difficulty with bowel movements or inability to have a bowel movement such as pain or distention of the abdomen. Moreover, the bowel have stools that are smaller in diameter than normal.
Complication
After undergoing this procedure, there are some side effects that would be encountered by patients. Patients should meet with physician/doctor if these side effects actually faced by the patient. If the patients likely to have allergic reactions with barium, the allergic reaction can be reduced by adding some flavour to the barium(strawberries, grapes, oranges and apple) are example of flavour that included in barium solution. If the patient felt itching or difficulty breathing, please let it know as soon as possible to any radiographers that work in that day. Medications are available to handle any allergic reactions. Patients may experience leakage of barium in any port or internal wounds in the gastrointestinal area unnoticed. Patients may also experience abdominal contraction, due to the effects of buscopan. Among the internal complications that may occur when some obstacles remain stomach contents into the impact that resulted in the precipitation of barium layer to prevent absorption of nutrients in the stomach. In addition, barium appendicitis caused by precipitation of barium in the appendix. Pharmaceutical agents such as drugs also have a negative impact on patients.
Some general Question that always been asked to the radiographer.
What is barium meal examination?
We will ask you to drink a white colored liquid called barium, it will help us (radiographers) to see pictures of your stomach in radiographic images.
The doctor will give you a little bicarbonate powder to eat or swallow. This will expand your stomach and help us (radiographers and doctors) to analyze the image when it becomes more clear. After that, the doctor will give injections buscopan called for relaxing your stomach muscles.
Can i bring someone who can accompany me during this examination?
Yes, but they can not accompany the you in the x-ray room, they must be in a safe place from the exposure(special circumstances).
whether I would have the side effect of this procedure?
you may feel overfed for a short while. You may also feel constipated that is feeling of not able to move solid waste(faeces) out of your body easily for a few days and require to take mild laxatives.
Is it normal for my stool to be white after drinking barium meal?
Yes, it is normal for barium meal procedure to have this result. This is showing that the barium is passing out of your system and it is completely normal.
What will happen if my child needs barium meal procedure?
The barium meal tests also done in children and babies in much the equal procedure as in adults. Your childs or babies does not need to fast as long as adults. Your child will be able to drink variety flavored such as banana, strawberry or chocolate).
Conclusion
Barium meal examination is to check to see structures in the abdomen with contrast media to help reveal the structure of the stomach. It facilitates the doctor knows the problems faced by patients and help patients to recover quickly.
