A barium swallow is an x-ray examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (hollow tube of muscle extending from below the tongue to the stomach). The pharynx and esophagus are made visible on x-ray film by a liquid suspension called barium. A barium swallow may be performed separately or as part of an upper gastrointestinal (UGI) series, which evaluates the esophagus, stomach, and duodenum (first part of the small intestine).
Because a postoperative leak around the sutures is a serious complication that may occur after esophagectomy, a barium swallow is generally performed before allowing an esophagectomy patient to resume taking food and liquids by mouth.
According to the American Journal of Roentgenology, studies support the use of high-density barium as part of the routine postoperative radiographic examination to rule out leakage before beginning oral feedings or if a leak is suspected. A water-soluble contrast agent should not be used (American Journal of Roentgenology, August 2003: 181(2); 415-420).