Upper GI Series

An upper GI series (gastrointestinal series) uses a special x-ray technology called fluoroscopy and a contrast agent called barium to show the upper part of the digestive system, including the esophagus, stomach, and the first part of the small intestine.

An upper GI with small bowel series is an upper GI with additional imaging of the entire small bowel taken over a period of time.

During both an upper GI and upper GI with small bowel series, your child will drink barium, which will fill and coat her GI tract. Barium is a milky-white contrast liquid that shows up on x-ray and allows the radiologist to see parts of the body clearly. It is an effective and safe contrast agent for infants and children.

A special type of x-ray technology, called fluoroscopy, is used to take pictures once the barium is in the intestine.

An upper GI series allows the radiologist to accurately diagnose many illnesses that affect the esophagus, stomach, and small intestine. Some reasons for an upper GI series include:

• abdominal pain
• bleeding into the gastrointestinal tract
• persistent vomiting
• poor weight gain

It is helpful to:

• give your child a simple explanation as to why an upper GI series is needed
• assure your child that you will be there for the entire time. If you are pregnant, you will not be able to be with your child when x-rays are taken. Bring another family member or friend to stay with your child.
• bring your child's favorite book, toy, or comforting object to occupy to use during waiting times

An upper GI series requires that your child not eat or drink for a period of time prior to the study. You will be given specific instructions when you make your child's appointment, but can use the following as a guideline:

• If your child is 0 to 6 months, he/she should not eat or drink two hours before the test.
• If your child is 6 months to 2 years, he/she should not eat or drink three hours before the test.
• If your child is 2 to 4 years, he/she should not eat or drink four hours before the test.
• If your child is 4 years or older, he/she should not eat or drink six hours before the test.

It is very important that you follow all preparation instructions, or the study may need to be rescheduled.

If your child is having an upper GI series with small bowel follow-through, you may bring food that your child likes to eat. After part of the test is finished, your child may eat.

When you arrive, please go to the Radiology check-in desk:

• A patient experience representative will check in your child and verify his or her registration information.
• A radiologist or technologist will explain the study to you and your child and answer your questions.
• Your child will change into hospital pajamas.
• For women and girls who have begun to have periods (menstruate), a pregnancy test will be required before the study begins.

You and your child will be taken to the procedure room, where the fluoroscope will be used to take x-rays. Your child will be awake at all times during the upper GI series.

• Your child will lie on the x-ray fluoroscopy table.
• A technologist will take a preliminary x-ray of your child's abdomen.
• Your child will be given the barium to drink through a straw while laying down under the x-ray camera. If your child is unable to drink the barium, the radiologist may place a thin tube through your child's nose to get the barium into the esophagus.
• The radiologist will take x-rays while your child drinks the barium and may roll your child back and forth on the table or push on your child's stomach to move the barium around.

An upper GI series without small bowel follow-through takes between 15 minutes and an hour.

If your child is also having an upper GI series with small bowel follow-through:

• The radiologist will want to watch the barium travel all the way through the small intestine.
• A technologist will take x-rays every 30 minutes during this time.
• This may take one to two more hours, and you will wait in the waiting room in between x-rays.

The x-ray camera will not touch your child during the test.

When the upper GI series is done, your child will be ready to go home or see his or her doctor if an appointment is scheduled.

• Your child can resume his or her usual activities and normal diet after the study.
• Your child should drink plenty of fluids to prevent constipation.
• Your child's stools may appear white for a couple of days after the upper GI series.
• If your child remains constipated, taking a mild laxative may help.

One of the radiologists will review your child's images and create a written report of the findings and diagnosis.

The radiologist provides a report to the doctor who ordered your child's upper GI series. The doctor will discuss the results with you.

Performing an upper GI series test in children poses unique challenges. Diagnostic Radiology at Boston Children's provides a soothing, kid-friendly environment with:

• pediatric radiologists, with extensive experience and training, perform the procedure
• technologists who have years of experience in imaging children from infancy to teenagers
• skilled staff who use age-appropriate distraction techniques to help comfort patients prior to and during the study
• equipment designed specifically for pediatric use, which means age-appropriate care for children
• protocols that have been adapted to keep radiation exposure as low as reasonably achievable without compromising the image quality