Barium studies of the upper GI tract are significantly less accurate than endoscopy for most upper gastrointestinal diseases and are recommended only in selected patients. Indications can include:-
Suspected oesophageal dysmotility (order cine barium swallow indicating clinical suspicion of oesophageal dysmotility).
Failed endoscopy. Rarely it may not be possible to insert the endoscope into the oesophagus. This can occur following surgery, radio therapy, caustic ingestion etc. Usually a guide wire can be passed under Xray control to allow dilatation. However, it may be considered advisable to outline the whole oesophagus before attempting dilatation.
Contra indications to intravenous sedation. Rarely cardiac or respiratory disease can be a contra indication to intravenous sedation.
Demonstrating anatomical relationships in a patient with a large paraoesophageal hiatus hernia.
Non barium Xray contrast (e.g. gastrograffin) if oesophageal perforation is suspected.
Defining anatomy preoperatively in large pharyngeal pouches.