NCMB 316 CARE OF CLIENTS WITH PROBLEMS IN NUTRITIONAL & GASTROINTESTINAL

METABOLISM & ENDOCRINE PERCEPTION, AND COORDINATION (ACUTE & CHRONIC)

MEDICAL
BARIUM ENEMA TEST
SURGICAL II
It is an X-ray procedure used to examine
LABORATORY ASSESSMENT the rectum and colon, often used as a complement to
lower gastrointestinal (GI) endoscopy.
BARIUM SWALLOW TEST
IT IS A DIAGNOSTIC TOOL FOR PATIENTS WITH:
It is a special imaging test that uses barium
and X-rays to create images of your upper o Lower GI bleeding
gastrointestinal (GI) tract. Your upper GI tract o Altered bowel habit
includes the back of your mouth and throat o Abdominal pain
(pharynx) and esophagus. o To screen for polyps and colorectal cancer

WHY ARE BARIUM SWALLOW TESTS USED? CONTRAINDICATIONS INCLUDE:

It can help a doctor identify problems in the food o Acute colitis/diverticulitis

pipe, stomach, or bowel. It may be also used if o Recent polypectomy or colonic biopsy
someone has any of the following conditions: o Older patients (>70 years old)
o Pregnancy
o frequent, painful heartburn
o gastric reflux, where food or acid keeps PATIENT PREPARATION (BOWEL
coming back up the food pipe PREPARATION)
o difficulty eating, drinking, or swallowing
This varies but often involves a period of low-residue
This test can give information about how the person diet and oral/laxative washout.
is swallowing, and if someone has any of the
 The patient should receive full instructions on
following in their food pipe, stomach, or the first part
preparation and the procedure.
of the bowel:  The patient is cannulated and may be given
intravenous antispasmodic medication (for
o ulcers
example hyoscine butylbromide) to make the
o abnormal growths procedure more comfortable and to aid the
o blockages passage of barium.
o narrowing  The patient is positioned in a left lateral position
on an X-ray table.
PROCEDURE  A digital rectal examination is then performed.
 A rectal catheter is lubricated and inserted into
 People who are undergoing a barium swallow the rectum. This has two connectors. One
should not eat or drink for a few hours before connector is for passing barium and the other is
the test. Sometimes, the doctor may ask the for insufflating air.
person to stop taking medication before the test.  The patient is placed prone.
 Some hospitals recommend not chewing gum,  Liquid barium is passed via a giving set into the
eating mints, or smoking cigarettes after catheter. It is passed slowly to prevent the
midnight the night before a barium swallow patient from experiencing discomfort or an urge
test. to defecate.
 The test takes around 60 minutes and will take  X-ray screening takes place as the barium is
place in the X-ray department of the hospital. A passed so the radiologist can observe filling. The
amount instilled depends on the patient. The
person will need to change into a hospital
radiologist stops once the rectum is filled and
gown.
the barium continues to pass around the colon.
 In the X-ray room, the person drinks the barium
The radiologist may change the patient's
liquid. It often has a chalky taste but can position as necessary to aid filling.
sometimes be flavored.  Once the contrast reaches the splenic flexure,
 A person will lie on a tilting table for part of the the patient returns to the prone position, and
examination. the air is insufflated. As air enters, the colon
 In some cases, a person will be given an inflates and the images of the mucosa become
injection to relax their stomach. clearer.
 A person will be standing for some parts of the  Radiography staff may assist in moving the
examination, and lying down on a tilting table patient to aid filling and to provide reassurance.
for other parts. This allows the liquid to travel  Screening continues until the radiologist
through the body, and for the radiologist and identifies the caecum, by seeing the appendix or by
seeing barium entering the small bowel.
radiographer to take a selection of images.
 Once the entire colon is filled further pictures are
 People do not have to stay in the hospital after
taken in individual positions to obtain complete
the test and are free to go home as soon as it is views.
complete. The results usually arrive within 1- 2  The radiographer ensures all pictures are valid.
weeks.  The rectum is emptied of barium and the catheter
is removed.

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REGINA SOPHIA CAPUNPON
NCMB 316 CARE OF CLIENTS WITH PROBLEMS IN NUTRITIONAL & GASTROINTESTINAL
METABOLISM & ENDOCRINE PERCEPTION, AND COORDINATION (ACUTE & CHRONIC)

 The patient passes barium for blockage in the esophagus, non-cancerous

several hours after the procedure. growths (polyps) or small cancerous tumors
o used to check symptoms or confirm a diagnosis
RISK AND SIDE EFFECTS is known as a diagnostic gastroscopy.
o used to treat a condition is known as a
 Patients may feel nauseous after a barium therapeutic gastroscopy.
swallow test or become constipated. Drinking lots
of fluids can help to relieve constipation. PROCEDURE
Symptoms of nausea should improve as the
barium passes through the system.  A gastroscopy often takes less than 15 minutes,
 It is normal for people to have white-colored although it may take longer if it's being used to
stools the first few times they use the toilet after treat a condition.
having a barium swallow test.  It's usually carried out as an outpatient
 Some people might worry about being exposed to procedure, which means you won't have to spend
radiation as part of the X-ray process. However, the night in hospital.
the amount of radiation a person is exposed to is  Before the procedure, your throat will be
minimal. numbed with a local anesthetic spray. You can
 Sometimes, the injection given to relax the also choose to have a sedative, if you prefer. This
stomach can cause temporary blurred vision. means you will still be awake, but will be drowsy
and have reduced awareness about what's
SPECIAL CONSIDERATIONS happening.
 The doctor carrying out the procedure will place
 People should not have a barium swallow test if the endoscope in the back of your mouth and
they are pregnant. ask you to swallow the first part of the tube. It
 If someone has glaucoma or heart problems and will then be guided down your esophagus and
needs to have a barium swallow, the doctor into your stomach.
may not give the stomach-relaxing injection.  The procedure shouldn't be painful, but it may be
 If someone has diabetes then the doctor will unpleasant or uncomfortable at times.
schedule a morning appointment for the barium
swallow. RISKS
 People who use insulin will be asked to miss A gastroscopy is a very safe procedure, but like
their morning dose and maybe the previous all medical procedures, it does carry a risk of
evening s dose. They should bring their insulin and complications. Possible complications that can occur
some food to have after the test. include:
 However, those who take long-acting insulin  a reaction to the sedative, which can cause
should continue taking this. problems with your breathing, heart rate and
blood pressure
MINOR COMPLICATIONS  internal bleeding
 tearing (perforation) of the lining of your
o Constipation esophagus, stomach or duodenum
o Abdominal discomfort
o Rectal bleeding ESOPHAGOGASTRODUODENOSCOPY (EGD)
o Flatus A test to examine the lining of the esophagus,
MAJOR COMPLICATIONS stomach, and first part of the small intestine (the
duodenum)
o Colonic perforation
o Hemorrhage HOW THE TEST IS PERFORMED?
o Oversedation
o Cardiac arrhythmia EGD is done in a hospital or medical center. The
procedure uses an endoscope. This is a flexible tube
GASTROSCOPY with a light and camera at the end.
It is a procedure where a thin, flexible tube
called an endoscope is used to look inside the THE PROCEDURE IS DONE AS FOLLOWS:
esophagus (gullet), stomach and first part of the
 During the procedure, breathing, heart rate,
small intestine (duodenum).
blood pressure, and oxygen level are checked.
It's also sometimes referred to as an upper Wires are attached to certain areas of the body
gastrointestinal endoscopy. The endoscope has a and then to machines that monitor these vital
light and a camera at one end. The camera sends signs.
images of the inside of your esophagus, stomach and  The patient receives medicine into a vein to help
duodenum to a monitor. you relax. The patient should feel no pain and
not remember the procedure.
WHY A GASTROSCOPY MAY BE USED?  A local anesthetic may be sprayed into the
mouth to prevent you from coughing or
o investigate problems such as difficulty gagging when the scope is inserted.
swallowing (dysphagia) or persistent abdominal  A mouth guard is used to protect the teeth and
(tummy) pain the scope. Dentures must be removed before the
o diagnose conditions such as stomach ulcers or procedure begins.
gastro-esophageal reflux disease (GERD)  The patient then lie on your left side.
o treat conditions such as bleeding ulcers, a

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REGINA SOPHIA CAPUNPON
NCMB 316 CARE OF CLIENTS WITH PROBLEMS IN NUTRITIONAL & GASTROINTESTINAL
METABOLISM & ENDOCRINE PERCEPTION, AND COORDINATION (ACUTE & CHRONIC)

 The scope is inserted through

the esophagus (food pipe) to the stomach and
duodenum. The duodenum is the first part of
the small intestine.
 Air is put through the scope to make it easier for
the doctor to see.
 The lining of the esophagus, stomach, and
upper duodenum is examined. Biopsies can be
taken through the scope. Biopsies are tissue
samples that are looked at under the
microscope.
 Different treatments may be done, such as
stretching or widening a narrowed area of the
esophagus.
 After the test is finished, the client will not be
able to have food and liquid until their gag
reflex returns (so you do not choke).
 The test lasts about 30 to 60 minutes.

MINOR COMPLICATIONS

o Constipation
o Abdominal discomfort
o Rectal bleeding
o Flatus

MAJOR COMPLICATIONS

o Colonic perforation
o Hemorrhage
o Oversedation
o Cardiac arrhythmia

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REGINA SOPHIA CAPUNPON