Version July 2025
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What is an upper gastrointestinal series? —
This is a test that uses X-rays to look at the upper digestive tract (figure 1). This includes the esophagus (the tube that connects the mouth to the stomach), the stomach, and the duodenum (the first part of the small intestine).
For the test, you typically drink a special liquid called "barium." This is a type of "contrast material." Then, the doctor takes an X-ray as the contrast material moves through your digestive tract. This can show if there are any problems with the organs or how food and liquid move through your body.
This test is also called an "upper GI series." "Series" means multiple X-rays are taken during the test. You might also hear it called a "barium swallow."
Sometimes, X-rays are only taken of the esophagus. This is called an "esophagram."
Why might I get an upper GI series or esophagram? —
Your doctor might do 1 of these tests if you have:
●Trouble swallowing
●Pain when swallowing
●Feeling like food gets stuck in your throat
●Unexplained coughing
●Unexplained heartburn
●Belly pain, nausea, or vomiting
●Signs of a leak after surgery of the upper digestive tract (such as weight loss surgery)
How do I prepare for the test? —
The doctor or nurse will tell you if you need to do anything special to prepare. They will probably ask you not to drink or eat anything for a period of time before the test.
Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:
●Any allergies you have
●Whether you could be pregnant
What happens during the test? —
When it is time for the test:
●You will change into a hospital gown.
●The staff will help you get in the right positions. This is so pictures can be taken from different angles.
●You will swallow a drink that contains contrast material, usually barium. Barium is a thick, chalky substance. It is usually flavored to make it easier to drink.
●For an upper GI series, doctors sometimes also use gas as a second type of contrast. If so, you might be asked to swallow a tablet or carbonated liquid. The gas helps the doctor see your digestive tract more clearly.
●As you swallow, the doctor will take an X-ray. This lets them watch the barium go down your esophagus. If you are having an upper GI series, they will take more X-rays as the barium goes through your stomach and the first part of your small intestine. Or they might use a type of imaging called "fluoroscopy," which is a continuous X-ray.
●The test usually takes about 30 minutes.
What happens after the test? —
You can go back to your normal activities after the test.
●You might feel bloated or have nausea for a short time.
●You will see barium in your bowel movements for a few days. This can make bowel movements look white or gray.
●You might also have constipation, which is when it is hard to have bowel movements. Drink plenty of water. This helps move the barium out of your body.
Your doctor will talk to you about when to expect your test results.
What are the risks of an upper GI series or esophagram? —
Getting an upper GI series or esophagram is usually very safe. There is a very small risk of getting contrast into your windpipe, called "aspiration." Your doctor will tell you about all the possible risks, and answer your questions.
In general, exposure to radiation from imaging tests might very slightly raise your risk of developing cancer later in life. But a single X-ray only exposes you to a tiny amount of radiation. The overall risk increases if you have to get many X-rays or other radiation-based imaging tests over time.
Patient education: Dysphagia (The Basics)
Patient education: Esophageal stricture (The Basics)
Patient education: Achalasia (The Basics)
Patient education: Acid reflux and GERD in adults (The Basics)
Patient education: Weight loss surgery (The Basics)
Patient education: Achalasia (Beyond the Basics)
Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics)
