Radiography of the stomach and duodenum is a necessary procedure in case of suspicion of the presence of various pathologies of the digestive tract. It is carried out by transillumination of the patient's body with x-ray radiation, followed by obtaining images of the affected organs. It should be borne in mind that the stomach is a hollow organ, and therefore its thorough examination with x-rays is not possible without preliminary filling with contrast agents, which include a suspension of barium salts and gas.
When X-ray is needed
Radiography of the stomach and duodenum is prescribed to identify and confirm the following diseases:
• various gastritis, • ulcerative pathology, • benign or malignant tumors, • polyps, • diverticulum.
The technique also allows you to determine the shape of the organs, their position, size and functionality of all departments, including the walls. The introduction of contrast makes it possible to assess the integrity of the mucous layer and the dynamics of the organs in moving the contrast medium and removing it from the body.
How to contrast
X-ray of the stomach and duodenum requires contrasting in two stages, which will allow to fully examine all the organs of the gastrointestinal tract:
• The initial filling is weak, it envelops the mucous layers and allows you to assess the state of organ folds. • The next stage is the full (tight) filling necessary for a detailed examination of all the physical parameters of organs and their functionality.
Contrast agents require different times to go through all sections of the digestive system. Barium leaves the esophagus after a few seconds, flowing into the stomach and being there for about an hour and a half. The first portion of contrast - 125 ml - is excreted for about 30 minutes, the remaining amount for 60 minutes. After administration, barium enters the duodenum after 30 seconds, its portioned passage through the organ lasts about an hour and a half.
The stomach should be free of food masses before the study, so a planned study is carried out in the morning and on an empty stomach. The minimum number of hours before an X-ray, during which you can not drink and eat, is eight. In addition, the day before the diagnosis, you can not use products that stimulate gas formation. These are legumes, cabbage, cucumbers, potatoes, dairy products, spices, coffee, chocolate. If emergency diagnosis is necessary, the patient is previously washed with a stomach.
In most cases, an overview radiography of the abdominal organs is first performed. According to it, the doctor determines the size and shape of the stomach, its relationship with neighboring organs. Then the patient drinks a barium mixture, which tastes like chalk and is absolutely safe for the body. After some time, the patient is placed in an X-ray machine, where the production of images begins. They are done in the supine position, on the stomach and back, as well as standing, which allows the contrast medium to be distributed evenly, and the doctor can get reliable information.
X-ray of the stomach with barium effects. How to prepare for the examination
Preparation for an x-ray of the stomach with barium should be carried out in advance. If everything is done correctly, then it will be possible to get high-quality photographs, which is important for further treatment. Doctors recommend at least two days to stay on a special diet.You should exclude from your diet foods that contribute to gas formation. Eat porridge for some time, eat lean meat, boiled fish and eggs. The prohibited products are:
- Drinks with gas.
- Cabbage in any form.
- Milk and any dairy products.
- Buns, bread, pies, cakes.
It is important to note that they do an x-ray of the stomach with barium on an empty stomach, so a person who is preparing for a diagnosis should not eat food either in the evening or on the day of the x-ray itself. It is forbidden to chew gum, smoke or even drink water. According to all the rules, the study should be carried out not less than eight hours after the last meal.
There are some cases when patients suffer from great flatulence or severe constipation, in which case, doctors recommend that before the study completely clean the body with an enema, and only then it will be possible to conduct an x-ray of the intestine with barium.
Before sending the patient for diagnosis, the doctor must check him for the presence of allergic reactions. Barium sulfate can cause allergies and not all patients know that he has a predisposition to allergic reactions. If the allergy is confirmed, then it will be possible to use another substance for contrast for research.
Who is being sent to the esophagus?
Esophagus x-ray is an informative and non-invasive diagnostic method
An x-ray of the esophagus helps to conduct a quick and completely painless examination and establish an accurate diagnosis by a non-invasive method. It is quite informative and indispensable in such situations when it is required to obtain information about the presence of foreign bodies in the esophagus.
Among the advantages of the method is its simplicity and speed of execution for the patient. The process itself usually takes from 20 to 40 minutes; it takes about the same amount of time to develop a film and obtain a specialist opinion. The procedure does not injure the patient and can be used in those cases when he does not want or cannot undergo endoscopy or gastroscopy because of the fear of introducing foreign objects into the esophagus or too strong and acute reactions to it. In such situations, performing an x-ray remains one of the best and most affordable procedures.
The radiographic product does not have a too pronounced taste or unpleasant odor; it resembles liquid antacid in consistency and color, so it usually does not have any special problems with drinking. In the same way, there are no complications with the withdrawal of the drug, because it is excreted unchanged and does not affect either the well-being or the state of health of the patient.
Despite the current view that the x-ray examination of the esophagus is somewhat outdated and not as informative as other, more modern methods, it has not completely lost its importance and value, and in some cases remains the only possible way to obtain accurate information about the state of health and functioning esophagus.
When a stomach x-ray is prescribed. When a fluoroscopy is prescribed
For more than 100 years, X-ray diagnostics have helped to identify serious gastrointestinal diseases.
X-ray of the stomach, carried out according to the traditional method (or using double contrasting), is recommended in the following situations:
- suspected ulcer or cancer of the stomach and duodenum,
- suspicion of protrusion of the wall (diverticulum) of the esophagus,
- black color of feces,
- frequent pain or tightness in the stomach and intestines,
- difficulty swallowing
- anemia or sudden weight loss for no apparent reason,
- after operations on the stomach and digestive organs.
An X-ray of the stomach is considered a non-hazardous procedure, however, it has several relative contraindications, among which:
- general serious condition
- massive bleeding from the digestive tract.
Preparation for fluoroscopy of the stomach with barium
An empty stomach is needed for the study: the last meal should be 6-8 hours before diagnosis.
Attention! Immediately before contrast fluoroscopy, you can not smoke, take medicine, alcohol or other drinks.
Another, special preparation for fluoroscopy of the stomach with barium in most individuals is not required.
Patients suffering from increased flatulence in the intestine, prepare before examining the stomach and duodenum 12 will help dieting for 2 or 3 days before the study.
It is recommended to exclude from the diet:
- fresh and rich bread,
- carbonated drinks,
- cabbage and pickles.
In rare cases, the doctor prescribes gastric lavage or cleansing enemas before the study.
Specific training in most cases is not required. When using contrast, hunger may be required 6-8 hours before the study. In some diseases, it is recommended at this time to stop taking medication, alcohol or certain foods (milk, carbonated drinks, etc.).
In urgent situations, gastric lavage may be preliminarily performed. Immediately before radiography of the stomach, the patient needs to undress to the waist, remove the chain. When using contrast enhancement with barium sulfate, the patient before the procedure needs to drink 200 ml of thick white liquid with a smack of metal in small sips.
An X-ray of the stomach with barium is a diagnostic procedure shown in the study of the surface and shape of the digestive organ and the detection of additional shadows in the lumen of its openings. The method is based on the integration of fluoroscopic and radiographic methods.
Barium sulfate is introduced into the body, which is able to reflect the state of the stomach and esophagus when exposed to x-rays. If an x-ray with barium of the abdominal region is performed, then the integrity of the intestinal walls is examined.
X-rays are not conducted by the air that accumulates in the intestine, therefore ulceration of the intestine is accompanied by the presence of free air outside the intestine.
To conduct an x-ray of the stomach and esophagus, the patient drinks a few milliliters of barium sulfate precipitate. The liquid is safe for human health in such a volume and is a thick white mixture of milky color and a touch of chalk. In case of individual intolerance to sulfates or barium salts, iodides are used as a contrasting substance.
After taking a few sips of barium sulfate, the doctor may ask you to drink an effervescent solution or Aeron tablets to enhance the contrast. Additionally, using sounding, gas can be introduced into the stomach to reduce its folding and smooth the surface of the mucosa. After the additional procedure, you must again take a few sips of barium sulfate.
Reception of barium provides the ability to view the walls of the stomach, the features of its peristaltic work in vertical conditions and the position of the digestive organ in the abdominal cavity. Viewing the digestive organ is done using a monitor.
As barium salt advances into the stomach, a series of images are taken reflecting the state of the esophagus and all surfaces of the stomach. Pictures are viewed later, on the basis of which a conclusion is issued. Often, shadows are displayed on the pictures, the presence of which is considered important in drawing up a conclusion.
During imaging, the patient is asked to hold his breath for a higher quality image and the reliability of the results of the method.
The procedure for filling the stomach with contrast agents and scanning organs usually does not last more than 25-30 minutes, but it happens that the procedure can be delayed for a longer time. When examining the stomach, the patient first takes an upright position, the stomach is visible through to the left.
The second part of the procedure is carried out in the supine position of the patient on a special table for x-rays, while the stomach is scanned in a horizontal plane. In order for the contrast fluid to evenly distribute along the walls of the stomach, the doctor periodically palpates the outside of the abdominal cavity in the stomach.
An X-ray of the stomach with barium will cost the patient no more than 3,000 rubles in Moscow clinics; in provincial clinics, prices may be less than 2,000 rubles for an examination.
Despite the safety of the procedure for health, not all patients are recommended a fluoroscopy of the digestive organ. You can not conduct an examination in the following cases:
- severe conditions with exacerbation of chronic diseases in a patient,
- hemorrhagic ulcerations of the stomach,
- allergic reactions and individual intolerance to barium salts,
- pregnancy at any time.
The procedure for fluoroscopy of the stomach is indicated in the presence of the following symptoms:
- fecal blood detection,
- difficulty swallowing,
- increased pain in the abdomen,
- sudden anemia with unexplained causes,
- the presence of seals during palpation of the abdominal region,
- rapid unreasonable weight loss.
Advice from the head of the gastroenterological department!
Gastroenterology (diseases of the gastrointestinal tract)
This x-ray examination in a dog is carried out with such clinical signs as pain in the abdomen, diarrhea, vomiting, an increase in the abdomen in volume, and so on. An x-ray of the dog of the abdominal cavity is carried out in two projections, on the back and in the lateral position. To exclude obstruction of the gastrointestinal tract, for example, with foreign objects, an abdominal x-ray with an x-ray contrast medium (barium) is performed. The dog is given barium with liquid (kefir) and a series of x-rays is taken, the passage of barium through the intestines is evaluated.
For pathologies of the esophagus, an X-ray is also carried out with an X-ray contrast medium (barium) and a series of X-rays are taken immediately after giving barium immediately.
X-ray with barium in a dog
An x-ray of a dog during trauma is one of the important diagnostic measures for detecting fractures, dislocations, chest injuries, abdominal bleeding, etc. The number of projections and x-rays taken is determined by the veterinarian, sometimes these studies are carried out under a soothing injection.
Dog forearm fracture
Orthopedics (joint diseases)
In orthopedic practice, the use of x-rays for a dog is one of the necessary for making the correct diagnosis. X-ray of a dog is used to diagnose:
- hip dysplasia
- elbow dysplasia
- diagnosis of POC of the shoulder joint
- diagnosis of arthrosis, arthritis of all joints
- diagnosis of spinal diseases
- diagnosis of rupture of the anterior cruciate ligament and much more.
Dog x-rays in the diagnosis of dysplasia are most often performed under sedation. Usually spend several x-rays of images in different projections. For other diagnostic purposes, x-rays can be performed without sedation, but only if the dog has a calm and non-aggressive disposition.
Dog Hip Dysplasia
When the purpose of the study is shown
In some cases, the described diagnostic study of the esophagus is resorted to in order to conduct additional diagnostics.Otherwise, examination is indicated as the only possible procedure when fibrogastroscopy or endoscopy cannot be performed for a number of practical reasons.
In addition to identifying various pathologies, the type of diagnosis under consideration will help in detecting and determining the location of foreign objects that could be in the esophagus when swallowing, along with food or otherwise.
Obvious indications for an x-ray of the esophagus are human complaints of pain and severe discomfort in the local area.
Among the indications for the diagnosis:
- prolonged heartburn
- swallowing disorders
- a feeling of heaviness in the local area,
- spasm at the time of swallowing a solid meal,
- acute soreness when passing the fluid through the esophagus,
- weight loss,
- gastro-food reflux (discharge into the oral cavity of an acidic taste of the contents of the stomach).
Examination of the stomach and esophagus during exacerbation of existing pathologies of the gastrointestinal tract is inappropriate. For example, in the case of an exacerbated ulcerative process, bleeding.
In such clinical cases, resort to alternative methods of diagnosis and subsequent surgical intervention.
Pulmonology (respiratory system diseases)
Typically, an x-ray of the chest cavity is carried out in the presence of such clinical signs as coughing, panting, etc., to diagnose pleurisy, the presence of fluid in the chest cavity, and inflammatory processes in the lungs. An x-ray of the dog of the chest cavity is carried out in two projections, on the back and in the lateral position.
Dog pulmonary edema
Nutrition features on the eve of the event
For patients with an established digestion process, a special diet is recommended for 2-3 days. Persons suffering from chronic constipation and flatulence should follow the principles of dietary nutrition for 3-5 days.
Experts advise to delete gas-forming products from the menu of the subject:
- fresh vegetables,
- bakery products,
- carbonated drinks,
- pork meat
- dairy products
Replace the above positions is cereal cereals (on water) with chicken broth with meat, fish and seafood, hard cheese. Cooking should be steamed or boil food in water.
Immediately before radiography, the patient’s stomach should be empty, because the food on the walls of the organs will not allow the contrasting mass to cover the mucous membrane, which may look like an oncological formation in the picture.
9-12 hours before the X-ray, the patient should not eat. A few days before the procedure, the patient should give up alcohol and cigarettes.
Before the examination, it is recommended that the digestive tract be cleansed of toxins and toxins. Drugs can partially help.
A few days before the procedure, the use of one of the following drugs is indicated:
- Activated carbon,
- Polysorb and several others.
Acceptance of such medications must be stopped 12 hours before the examination.
If the patient treats an ulcer, suffers from chronic gastritis or other diseases, the course of which involves the constant use of drugs, then the use of drugs also has to be suspended for 1-2 days. These funds are aimed at changing the functional activity of organs - you will not have to count on an objective result when using them.
Survey: varieties of methods and their characteristics
How do fluoroscopy of the esophagus and stomach? Before proceeding to the diagnosis, a survey x-ray of the internal organs of a person is made, which allows one to judge the condition and presence of gas accumulations in the surrounding tissues.
The study can be carried out according to three methods:
- Traditional way.
- Trendelenburg position.
- Using double contrast.
During the examination (by any of the methods), the specialist will determine the lesions of the mucous membranes, will assess the patency of the organ as the contrasting contents (barium sulfate solution) will pass inside the digestive tract.
During pregnancy, an x-ray is carried out for the presence of the number of fetuses, their size, pathological conditions during pregnancy and childbirth are revealed. An x-ray examination in a planned manner is preferably carried out by dwarf dogs (that terrier, chihuahua, spitz) starting from the 50th day of pregnancy for the presence of a pathological size of the fetus. X-rays are performed in the ventro-dorsal projection (on the back), sometimes a lateral projection is also used.
When diagnosing dogs with neurological problems, an X-ray is performed with a study such as myelography for the presence of compression effects on the spinal cord in case of intervertebral disc disease. X-rays are also given to dogs in the diagnosis of atlantoaxial instability in dwarf dog breeds and so on. The number of x-rays of images and projections is determined in each case by a veterinarian.
X-ray of the stomach with barium, how to prepare. What is barium x-ray for?
A fluoroscopy is performed in real time, if during X-ray of the stomach with barium the preparation was carried out in compliance with the required conditions, the doctor monitors the motility of the stomach using the image transmitted to the monitor. The patient takes barium salts mixed with water, after filling the stomach, they are excreted into the duodenum. This examination is necessary when there are symptoms indicating the presence of:
• inflammation, • ulcerative pathologies, • the development of neoplasms, • obstruction, • impaired motor skills, • prolapse of the stomach or loss of its wall, • various types of injuries.
How is the procedure
All types of x-ray examinations of the stomach are performed on an empty stomach. Moreover, additional procedures are based on the type of examination. 15 minutes before the start of the examination, the patient drinks about 250 ml of the composition of barium sulfate, in addition, aeron can be prescribed to relax the intestines. If a specialist prescribes double contrasting - barium sulfate with air - before the start of X-ray diagnostics, increased cleaning of the gastrointestinal tract is required. Usually fortrans are used for this purpose. Before performing the procedure, a trial test is necessary to exclude the possibility of allergic reactions. If within 15-20 minutes after taking a small dose of the drug, skin reactions and pathologies of organs are not observed, a full-fledged procedure is performed and radiography is performed. The images are taken at different angles, the main provisions of the patient are vertical and horizontal. In the case when pathological changes are observed in the images, fibrogastroscopy can be additionally prescribed. But normal FGDS is carried out before the appointment of an X-ray, given that the procedure does not require special preparation. Also a plus is the absence of the effect of radiation on the body.
X-ray of the esophagus, stomach and intestines requires a certain preparation of the patient for the upcoming event. Given that the procedure will be carried out with contrast, he needs to try and achieve the maximum purity of the investigated organs. So, for the purity of the esophagus, it is enough to refrain from evening meals on the eve of the examination, and, accordingly, do not have breakfast in the morning before the procedure.
What is gastroscopy of the stomach?
The same principle should be followed if you need to undergo an x-ray of the small intestine and stomach. Additionally, for 4–5 days, the patient should limit himself in taking foods that lead to increased gas formation in the stomach and intestines.Since during radiography (creating x-ray images), gas bubbles can look like various pathological changes in the organs under investigation.
Therefore, in order to prepare for this procedure, you can not eat legumes, pastries and bakery products, fatty meats and fish, cheeses, raw vegetables and fruits. And you should definitely exclude the use of alcohol, strong coffee and tea, carbonated drinks and water. And several hours before the start of the study refrain from smoking.
With the appointment of an x-ray of the colon from the patient, it will be necessary to thoroughly clean the intestinal lumen from feces, which can be done in several ways. These include cleansing with enemas, taking laxatives and cleansing with special drugs that interfere with the absorption of fluid from the intestines.
Special preparations, such as Fortrans, Fleet, Duphalac, give an excellent cleansing effect, giving the doctor a thorough examination and diagnosis of the required organs. Therefore, before making an x-ray of the intestine, the patient must be warned about the need for high-quality cleansing and give appropriate recommendations.
That is, they explain how to carry out all activities that ensure the perfect purity of organs. Because radiography of the stomach, esophagus, small and large intestine shows all possible violations only with strict observance of all the rules of the preparatory process. Otherwise, you will have to repeat the procedure, which will cost additional time and money.
X-ray examination of the stomach. Indications and contraindications
An abdominal x-ray is an inexpensive and affordable diagnostic method. Radiation exposure is minimal. The procedure helps to quickly eliminate (or confirm) serious diseases. Recommended in the following cases:
- suspected presence of ulcerative pathology in the patient,
- with inflammatory diseases,
- the probable presence of tumors of benign or atypical etiology,
- with possible deforming processes.
X-ray of the stomach is prescribed during the development of a certain clinical picture: a sharp set or weight loss, constant pain in the epigastric region, frequent manifestation of heartburn, blood impurities in the feces.
Diagnosis is carried out according to the doctor’s recommendations, first you need to visit a gastroenterologist. The procedure has some contraindications, they are characterized as absolute and relative.
Pregnancy is a relative contraindication, the diagnosis is carried out with the permission of the obstetrician-gynecologist, but not earlier than in the third trimester. Women who are in the period of a lactation, are required to temporarily cancel feeding.
Internal bleeding is also a contraindication to the study. This condition distorts the diagnostic results. After eliminating the bleeding, an x-ray is available and will indicate the reasons that provoked this process.
An X-ray is not assigned to patients in serious physical condition in order to avoid deterioration. Also, a picture of the stomach with barium is not prescribed in the presence of an allergic reaction to the contrast medium.
Interpretation of Results
According to the results of a radiography of the stomach, the structure of the walls of the lower parts of the esophagus, cardiac sphincter, stomach, pylorus, and the initial parts of the duodenum is estimated. Defects of the wall, its structural changes indicate the presence of ulcers, gastritis, protrusions, and tumors. With stenosis, the lumen of one of the departments of the organs under investigation is significantly reduced, the opposite walls adjoin one another. In favor of the presence of GERD, structural abnormalities of the cardiac esophageal sphincter are indicated.
A perforation of the wall of the stomach is indicated by a defect through which a contrast agent enters the abdominal cavity and an accumulation of air under the domes of the diaphragm. Anomalies of development and postoperative changes depend on the individual characteristics of the patient and the treatment. Based on the data obtained during the radiography of the stomach, the attending physician makes a diagnosis or directs the patient for further examination.
Indications for x-ray examination of the esophagus
X-ray examination helps to identify the presence of pathological changes in the esophagus, their localization. Assign it when the patient complains:
Using x-rays determine the location of the foreign body of the esophagus.
X-ray examination is the optimal method for the diagnosis of various pathologies of the esophagus:
In addition, an X-ray examination is necessary:
- for the detection of mediastinal cysts, intrathoracic tumors, lymphadenopathy,
- when diagnosing a hiatal hernia,
- before surgery or radiation therapy for esophageal tumors.
As an auxiliary method of research, an esophagus x-ray is prescribed for the diagnosis of abnormalities of the aortic arch, and for detecting the degree of enlargement of the heart (especially with mitral defects).
Are there any contraindications for x-ray examination of the esophagus
X-ray examination is most optimal for detecting pathologies of the esophagus. It is carried out even for seriously ill patients, especially if endoscopy and other traumatic research methods are contraindicated.
The disadvantage of the study is the additional radiation exposure, the use of contrast agents. Without contrasting, it is impossible to see changes in the esophagus (due to its anatomical location, structure).
Not recommended for:
- Pregnant Before prescribing radiation diagnostics, the doctor must assess the benefits and harms of the study and, if possible, do without additional radiation.
- With individual intolerance to contrast agents. Now this is not a problem. A wide variety of drugs are used, of which it is quite possible to choose the most harmless.
- An x-ray using barium sulfate is undesirable if there is a suspicion of perforation, fistulas, esophageal fistulas, infringement of a hiatal hernia, or bleeding from the upper gastrointestinal tract. Water-soluble contrast agents (triiodinated organic compounds) are used.
So that the study does not cause harm and with its help it is possible to obtain as much valuable information as possible, it is necessary to select the most effective methodology.
Method for x-ray examination of the esophagus
The study is carried out on an empty stomach. And it begins with the usual panoramic fluoroscopy and radiography of the chest, abdominal cavity. This is necessary to exclude pathological changes in other organs. Then begin x-ray examination of the esophagus.
The patient must be examined in various positions, changing the direction of the x-ray beam. In different poses, it is easier to diagnose a particular disease:
- Vertical. Diagnoses esophageal strictures.
- Horizontal More effective for studying the motility of the esophagus, identifying sliding hiatal hernias.
- Location of Quincke, Trendelenburg. The patient lifts the pelvis or legs. They should be located above the head. This is necessary to diagnose a hiatal hernia.
For the effectiveness of the study, x-rays are carried out before the introduction of a contrast suspension and after. To obtain reliable results, adhere to a certain technique.
Standard Esophageal X-ray Technique
After carrying out a survey radiography, they begin to study the esophagus with the help of contrast agents. The survey consists of two stages:
- liquid contrasting suspension
- with tight filling.
To study in detail all phases of the activity of the esophagus, its morphological structure, function, research is carried out in this way:
- The patient drinks 1 sip of liquid contrast medium. This allows you to evaluate the act of swallowing, the advancement of suspension through the pharynx, esophagus, and its entry into the stomach. There is no danger of clogging the esophagus with strictures.
- The patient takes barium paste (or another thick contrast medium) for tight filling. It slowly moves along the esophagus and allows you to more accurately assess the condition of the esophagus.
To diagnose various pathologies of the esophagus, the standard methodology is changed.
Additional methods of x-ray of the esophagus
If a esophageal stricture is suspected, instead of barium suspension, the patient is sometimes given a tablet of barium sulfate. Over the narrowed area, it lingers until it crumbles.
To determine the localization of foreign bodies of the esophagus, use the methodology of S. V. Ivanova-Podobed:
- The patient drinks 10-15 ml of thick contrast agent. Observe in which of the esophagus the suspension was suspended.
- The patient drinks 2-3 sips of water. From the mucous membrane of the esophagus, the contrast agent is washed off, and barium remains on the foreign body.
For a detailed study of the relief of the mucosa, double contrasting is recommended:
- A probe is inserted into the esophagus. 10 ml of liquid contrast medium is admitted through it.
- The patient takes a breath. The glottis must be closed.
- Up to 200 cm 3 of air is blown through the probe. This achieves a clearer picture of the relief of the mucosa.
X-ray examination is sometimes necessary in conditions of hypotension. To do this, intravenously administered:
- atropine sulfate and calcium chloride,
Then examine the esophagus.
Using these techniques, functional disorders, the presence of neoplasms, pathological changes in the mucosa are revealed. To establish an accurate diagnosis, often one X-ray examination is not enough. It is complemented by:
After examining the esophagus, it is advisable to conduct an x-ray of the stomach. This is especially necessary for cardiac insufficiency. Often, tumors of the stomach and other diseases cause pathological changes in the esophagus.
Which doctor to contact
Depending on the anamnesis, patient complaints, suspicion of a particular disease, the methodology of the study is determined. Therefore, with complaints of dysphagia, chest pain, frequent heartburn, belching, you should contact a gastroenterologist. And he will, if necessary, send to the radiologist, prescribe an additional study. In the presence of a foreign body and severe pathologies, it is necessary to consult a surgeon. If a neoplasm is found on an x-ray, then a histological examination is mandatory. If the tumor is malignant, they are referred to an oncologist.
Basics of X-ray examination of the stomach and esophagus
The X-ray method is considered the research standard for various organs and systems of the body. For any part of the body, you can apply this diagnostic method and get the necessary information about its condition. Since the discovery of X-rays in 1895, many conclusions have been drawn on its use. Harm and Benefit x-ray repeatedly studied, but today it can be confidently argued that thanks to the improvement of technology, the harm from the use of x-rays has become almost zero.
X-ray examination of the stomach and esophagus did not begin immediately, but only after the possibility of using contrast agents was discovered.
Today X-ray of the stomach and esophagus is the main method for the diagnosis of diseases such as gastritis, esophagitis, gastric ulcer, tumor formations of these organs.X-ray examination of the stomach and esophagus is indispensable in modern medicine.
The nature and properties of x-rays
X-rays are electromagnetic waves. From the point of view of physics, x-rays are the same radiation as sunlight. A distinctive feature of x-rays is the special wavelength (from 10 -7 to 10 -12 m) This wavelength is not perceived by the human organ of vision. X-rays are also found in nature. Their source is celestial objects, the radiation of which reaches the Earth.
X-rays have the following characteristics and qualities:
- penetration ability
- activation of chemical reactions.
The harm of x-rays is the effect of ionization. Under their influence, neutral atoms and molecules of the human body turn into ions, the chemical activity of which is higher. So free radicals are formed, which destroy proteins, lead to various mutations in the genetic material of cells. As a result of the action of ionizing radiation, malignant tumors can form, however, in modern X-ray systems, the amount of radiation is so small that it does not cause any negative consequences for the patient.
A method of producing x-rays in medicine. X-ray
X-rays are created through the use of the so-called X-ray tube. This device allows you to create x-rays from the energy of electric current. X-ray tubes differ in the power of the emitted x-ray radiation, however, the principle of their arrangement as a whole is the same and unchanged from the very first use of x-rays.
Simplified x-ray tube consists of the following elements:
- electrodes (anode and cathode),
- heat-absorbing substances for heat removal,
- water cooling system.
X-rays are obtained due to the fact that x-rays are delayed by the body to varying degrees. Fabrics with a higher density (bones) retain more x-rays, and soft tissue (including stomach and esophagus) - smaller. An x-ray film treated with a special photosensitive composition is colored differently depending on the energy of the x-rays that have fallen into its different areas. The result is a contrast x-ray image. To study soft tissues, additional x-ray methods were invented, such as the use of contrast agents.
Why is contrast medium used for x-rays of the stomach and esophagus?
Examination of the stomach and esophagus using a conventional x-ray is a fairly rare procedure.This is due to the fact that the value of this study is low. The soft tissues of the stomach and esophagus differ slightly in density from neighboring organs (lungs, liver, heart), so they merge into the big picture. Sometimes it is difficult to distinguish even the contours of the stomach and esophagus on a panoramic x-ray.
To study the stomach and esophagus using x-rays, a proposal was made to fill the cavity of the stomach and esophagus with a contrast agent that can “stain” these organs in the chest and abdominal cavities and facilitate their study. Barium sulfate has been proposed as such a substance. It has a white color, a neutral taste and a viscous texture. Barium sulfate is completely harmless to use, since it does not interact with the digestive tract. This substance is diluted in a concentration of about 1: 2 with water, after which it is drunk in small sips. Due to the liquid consistency, barium suspension moves relatively quickly along the gastrointestinal tract, reducing the time of the study.
Gases are also used as contrast agents during examination of the stomach and esophagus. For the gastrointestinal tract, ordinary air, nitrous oxide, carbon dioxide are used. They are introduced after barium suspension, in order to stretch the investigated organs and better see the relief of the inner shell. Since gases completely transmit x-rays, they stain the organ black. The simultaneous use of barium suspension and gas is called double contrasting.
The contrast is prepared mechanically, the barium mass is drunk by the patient. They control the process of its passage through transmission.
The patient is lying on his back. Such a posture provides a uniform distribution of the contrast agent and the possibility of a detailed study of the inner surface of the organ.
Immediately the contrast is in the esophagus. The patient exhales, the food sphincter relaxes and the component is in the stomach. After the evaluation of the mucosa is done, a person drinks another 200 ml of contrast mass. After that, in various projections, the shape, location, size of the stomach is revealed and the process of emptying it is evaluated.
X-ray according to Trendelenburg
Using such a technique, a hernia is determined. Preparation for an x-ray of the stomach and esophagus in the described case remains the same.
After the contrast agent is drunk, the patient is laid on the couch, lifting the pelvis at an angle of 45 °.
A certain position of the patient ensures that the mixture enters the intestine through the lumen of the diaphragm - a clear contour appears. As a result, the doctor can better visualize the diaphragm, a hernia in the lumen of the esophagus.
The described approach to diagnosis is contraindicated in case of fluid concentration in the peritoneum, with intestinal oncology, malfunctions of the heart and respiratory organs.
This approach to the diagnosis of diseases of the esophagus and stomach involves the introduction into the cavity of organs, in addition to the contrast agent, also air. A method is used to inject air into the tube. During the study, the folds are straightened - barium is better distributed.
The appearance of the motor function of the organ can be considered peristalsis - rhythmic contractions of the circular muscular tissue. The specialist monitors the depth, frequency, speed indicator of peristaltic waves and concludes with respect to motor function.
Through this technique, tumors, polyps and other pathologies of the mucosa hidden in the folds of the organ are also detected.
In the absence of pathologies, the picture of the esophagus on an x-ray will be presented to the doctor as follows:
- the absence of changes in the size and shape of the body,
- uniform wall thickness
- the absence of polyps, tumors, cysts, scars on the surface of tissues,
- the absence of foreign objects in the body cavity.
In the table below, we present the probable local diseases and their radiological manifestations:
|Diverticulum||The protruded, stretched wall of the esophagus. The mucous organ is sandwiched between muscle fibers - a specific bag is formed|
|Esophagus dyskinesia||Symptoms of inflammation of the mucous organ, the presence of ulcers on the surface|
|Hernia of the esophagus||A certain area of the stomach is located in the chest area or a section of the esophagus, previously placed above the diaphragm, falls into the peritoneum|
|Esophagitis||Swelling of the mucous membranes, a malfunction of the motor process, a decrease in the tone of the esophagus|
|Ulcers||Various in shape and size characteristics of the formation, located on the surface of the esophagus (often near the entrance to the stomach)|
|Benign neoplasms||Formations similar to polyps with a homogeneous structure and a clear shape|
|Malignant tumors||Formations that do not have clear contours and shapes|
Sometimes, to make an accurate diagnosis, assessing the condition of the esophagus on an x-ray is not enough. It is required to evaluate the condition of other organs. For example, the esophagus can be deformed, squeezed, displaced due to the pathological condition of a nearby organ.
Air in the enlarged esophagus.
X-ray of the esophagus seems to be a kind of non-invasive, painless method of establishing a specific diagnosis in a short time. The method is highly informative and is indispensable in cases where it is necessary to establish the presence of a foreign object in the esophagus.
Benefits of Esophageal Radiography:
- Speed of carrying out. The procedure itself takes 20-40 minutes.
- No risk of injury. The method is an excellent alternative to endoscopy and gastroscopy, when the patient is uncomfortable with the introduction of a foreign object or these procedures are contraindicated to the patient.
- Painless and easy. To undergo the procedure, the patient needs to drink a solution of barium sulfate, which does not have a pronounced taste or unpleasant odor and is similar in characteristics to liquid antacid. Therefore, there are no problems with its ingestion. Withdrawal of the solution also occurs without consequences in relation to the patient's well-being and state of health.
The advantages of radiography to this day remain relevant, and in certain clinical cases, they are the only way to get a real picture of the functionality and condition of the stomach and esophagus.
The cost of conducting the examination of organs using barium depends on the location of the diagnosis and the corresponding pricing policy of the clinic. The average price for an x-ray of the esophagus is 300-1000 rubles.
X-ray of the esophagus is a simple and effective diagnostic procedure used to identify local pathologies and foreign objects in the body cavity. Unambiguous indications for the examination are pain and discomfort in the epigastric region.
The study is preceded by cleaning the patient's digestive tract from toxins. This is ensured by following the diet for several days before an x-ray. The procedure is carried out according to one of three methods and takes no more than 40 minutes. The interpretation of the results of the radiograph is carried out by the radiologist over the next 30 minutes.
What is radiography
X-ray is a special method for examining the internal organs of a person, thanks to which doctors can get the desired image on a picture or x-ray film.
Radiography has two main varieties:
- Diagnostic method with contrast.This means that during the examination, the patient must take a special contrast agent, thanks to which his internal organs will be much more clearly visible in the finished image.
- The double contrast method provides for the procedure with barium. Most often, this method is used to assess the elasticity of the walls in the patient’s stomach.
Indications and contraindications for radiography
X-ray of the esophagus and stomach is prescribed for suspected diseases and pathologies:
- Stomach ulcer.
- Tumor of the esophagus or stomach.
- Gastritis in the stomach.
- Duodenal ulcer.
- Pathology of the development of the stomach.
- Monitoring the condition of the esophagus or stomach after surgical treatment.
- Pathology of the esophagus.
- Suspicion of a foreign object entering the esophagus.
In addition, direct indications for radiography of the esophagus and stomach are the following symptoms:
- acute pain when swallowing,
- pain in the esophagus or stomach,
- burning sensation when swallowing,
- navel pain
This study is contraindicated in such cases:
- pregnancy, especially on the first lines of its course (this study should not be carried out so as not to harm the baby and its development),
- severe condition of the patient
- prolonged gastric bleeding,
- individual intolerance by the patient of a contrast medium,
- allergic to iodine.
Causes of the development of diseases of the stomach and esophagus
Most often, diseases in these organs appear for the following reasons:
- Eating oily, overly spicy, or fried foods.
- Binge eating.
- Alcohol abuse.
- Eating food with harmful chemical additives.
- A burn or chemical damage to the mucous membrane of the stomach and esophagus.
- The ingress of a foreign object into the esophagus, due to which its mucosa is damaged.
How is the procedure
Radiography is performed in the following sequence:
- The patient becomes straight behind the x-ray screen.
- The doctor receives an image of his stomach and esophagus.
- Next, the patient drinks several sips of barium contrast. Sometimes the course of this pharynx is also recorded to better see how the fluid will pass through the esophagus.
- After that, pictures are taken from the side.
Typically, young children drink barium contrast without resistance, but if the child does not want to drink this substance, then it is injected into his stomach using a small medical tube.
When examining infants, it is customary to use special moving platforms. This will enable the radiologist to see the baby’s internal organs more clearly.
Teens are often tested with double contrast.
- Then the patient lies down on the table and the pictures are taken in a supine position (this helps to identify a hernia of the esophagus, as well as esophageal reflux).
- As a rule, the total duration of such an examination is 20 minutes.
What to expect after the completion of the examination
After examining the patient’s finished images, the doctor will draw up a detailed report, which is then transmitted to the attending physician. Based on the information received, the doctor will select the necessary treatment for each patient individually (depending on the diagnosis, age and condition of the patient).
It is important to know that for an ordinary person without a special medical education it is practically impossible to accurately decipher the x-rays, therefore it is better to entrust this to an experienced specialist.
Additional pathologies that can be detected after radiography:
- A change in the lumen of the stomach or esophagus. This concept refers to the narrowing or expansion of the lumen of organs with a growing oncological pathology.
- Dilation of the lumen can also be with diverticula.
- Deformation of the investigated organ.
- Violation of the structure or integrity of the body.
- Filling with contrast medium one or more parts of the organ is inherent in a stomach ulcer.
Advantages and disadvantages of radiography of the esophagus and stomach
This examination has the following advantages:
- It helps to diagnose the disease in time, due to which the patient has a better chance of proper treatment and an early recovery.
- Radiography is a relatively safe and painless procedure.
- The study allows you to accurately view the condition of the internal organs of the patient.
- It does not cause any allergic reactions.
- Does not leave active harmful radiation after the procedure.
- It does not cause any side effects.
Despite a number of advantages, radiography has the following disadvantages:
- With frequent studies, radiography increases the risk of developing cancer pathologies in the body.
- The required dose of radiation for each patient is different.
- Very rarely, patients are allergic to flavors that are mixed in barium fluid.
- There is a risk of barium retention in the intestines, which can cause short-term intestinal obstruction.
- Radiography should not be performed during pregnancy.
- Sometimes after this procedure, patients complain of an overly thick consistency of barium contrast, which makes it difficult to drink. In addition, liquid barium has a pronounced taste of chalk, so without fruit flavors it is very difficult to drink.
- Some discomfort to the examined people makes it necessary to change the position of the body during the procedure.
- After taking barium, nausea and bloating can be felt.
- When using special liquid soda, a person may have nausea bloating.
- Two days after the procedure, the stool may become grayish due to the presence of barium in the body.
- Sometimes after taking this contrast, people suffer from constipation and indigestion, therefore, in the first days after exposure, it is recommended to drink plenty of fluids.
Prevention of the development of various diseases of the stomach and esophagus
To keep these organs healthy, you must adhere to these recommendations:
- Refuse bad habits (drinking, smoking).
- Healthy food.
- To eat in small portions 4-5 times a day.
- Drink plenty of fluids.
- Do not eat too hot food.
- Chew each piece of food thoroughly.
- Avoid stress.
- Keep a food diary in which to write down everything you eat. This will control the menu and protect against the desire to eat "something tasty, but at the same time harmful."
Today, radiography is considered a very effective procedure for the diagnosis of a variety of pathologies of the stomach and esophagus. Immediately after the initial examination of the patient, the doctor prescribes it in order to see the complete condition of the internal organs.
In addition, experts recommend radiography for prophylaxis at least once a year. This will help to identify the disease in time at the initial level of its development, which will greatly simplify the treatment.
Evidence for X-ray examination of the esophagus
X-ray examination helps to identify the presence of pathological changes in the esophagus, their localization. Assign it when the patient addresses complaints:
Using x-rays determine the location of the foreign body of the esophagus.
X-ray examination is the optimal method for the diagnosis of various pathologies of the esophagus:
In addition, x-ray examination is necessary:
- for the detection of mediastinal cysts, intrathoracic tumors, lymphadenopathy,
- when diagnosing the keel of the esophageal opening of the diaphragm,
- before surgery or radiation therapy for esophageal tumors.
As an auxiliary method of investigation, an esophagus x-ray is prescribed for the diagnosis of abnormalities of the aortic arch, and for the detection of the degree of enlargement of the heart (especially with mitral defects).
Are there any contraindications for x-ray examination of the esophagus
X-ray examination is most optimal for detecting pathologies of the esophagus. It is even escaped by seriously ill patients, especially if endoscopy and other traumatic research methods are contraindicated.
The disadvantage of the study is the additional radial load, the use of contrast agents. Without contrasting, it is impossible to see changes in the esophagus (due to its anatomical favor, structure).
Not recommended for:
- Pregnant Before prescribing a radial diagnosis, the doctor must assess the benefits and harms of the study and, if possible, become without additional radiation.
- With individual intolerance to contrast agents. Now this is not a problem. The most diverse drugs are used, of which it is quite possible to choose the most harmless.
- An X-ray with support of barium sulfate is undesirable in cases of suspected perforation, fistulas, esophageal fistulas, infringement of the keel of the esophageal opening of the diaphragm, and bleeding from the upper sections of the gastrointestinal large intestine. Water-soluble contrast agents (triiodinated organic compounds) are used.
So that the search does not bring harm and with its help it is possible to obtain as much valuable information as possible, it is necessary to adjust the most effective methodology.
Which doctor to contact
Depending on the anamnesis, patient complaints, suspicion of a particular disease, the research methodology is determined. Therefore, with complaints of dysphagia, sternal ailments, frequent heartburn, belching, you should contact a gastroenterologist. And if necessary, he will rush to the radiologist, will prescribe an additional study. In the presence of a foreign body and serious pathologies, it is necessary to consult a surgeon. If a neoplasm is found on an x-ray, then a histological examination is certainly prescribed. If the tumor is malignant, they are referred to an oncologist.
In which cases do an x-ray of the esophagus and stomach
X-ray of the esophagus and stomach it is often prescribed for gastrointestinal diseases, as an additional or main, and often the only possible examination method (when it is impossible to enter an endoscope due to organic obstacles or the patient's panic fear before the examination).
Given that the procedure is associated with x-ray radiation, it can only be prescribed by a doctor.
Existing methods of X-ray examination (X-ray examination, X-ray with simple and double contrasting of the organs with barium, CT examination, including multi-helical CT, fluoroscopy), various patient styles (according to Trendelenburg) make it possible to identify almost any pathology of the esophagus and stomach. For examination of the upper esophagus and larynx, the method of G.M. Zemtsov is used.
An x-ray of the esophagus and stomach is carried out using barium contrast, which fills not only the esophagus and stomach, but also the intestines. Thus, with one examination, you can see the condition of the entire digestive tract. Barium resembles a mushy mass, the consistency of sour cream, white, tastes like chalk.
Types of fluoroscopy of the esophagus
An X-ray examination of the esophagus and stomach is an optimal procedure that is easily tolerated by the patient. It is used even in critically ill patients when endoscopy is difficult. With fluoroscopy, all segments of the digestive tract and stomach are perfectly visible, you can examine the duodenum, small and large intestines.
The main types of simple x-ray diagnostics are:
- panoramic fluoroscopy,
- radiography with contrast,
- double contrast radiography,
Panoramic radiography of the esophagus and stomach
Survey radiography, as a separate diagnostic method, due to low information content, is now practically not used. The fact is that the density of the upper gastrointestinal tract is almost the same as the surrounding tissues (heart, liver, lungs). Therefore, in the picture, the esophagus and stomach look like a poorly defined spot, which is difficult to describe.
Sometimes the attending physician asks the radiologist to see the state of the mediastinum, and the relative position of the organs, then a panoramic radiograph is indispensable.
In addition, panoramic fluoroscopy is an obligatory first step in the X-ray diagnostics of the digestive tract before the patient receives contrast.
X-ray of the esophagus and stomach with barium
In order to better consider the esophagus and stomach during radiography, to identify their pathology, various contrast agents are used. There are a large number of contrast agents; barium sulfate is most commonly used. If you are intolerant of one contrast agent, you can replace it with another, more suitable. If fistula is suspected, the suture of the operated esophagus is inconsistent, or other destruction of the esophagus wall is used, water-soluble contrast agents (triiodinated organic compounds) are used.
Esophagus x-ray with double contrast
For detailed visualization of the mucosa with x-rays of the esophagus and stomach, contrasting is used with two substances: air and barium.
This technique allows you to identify many pathologies of the body, among them oncological diseases in the early stages.
But it is necessary to warn the patient that after the study there may be a violation of the stool (constipation, diarrhea), these disorders are not dangerous and pass away in a few days on their own.
How do x-rays of the esophagus and stomach in the Trendelenburg position
X-rays by this technique are used to detect hiatal hernias.
The technique is based on the special laying of the patient when the pelvis is raised in relation to the head.
- with dysfunction of the heart and lungs,
- with the accumulation of exudate (pus, blood),
- with oncological pathology of the intestine and peritoneum.
How is fluoroscopy of the esophagus and stomach
The entire fluoroscopy procedure with contrasting the esophagus and stomach is carried out in several stages:
- An overview x-ray is performed.
- The patient is given a sip of liquid barium contrast. The entire act of swallowing and the movement of suspension in the stomach are traced on the screen.
- The esophagus is tightly filled with contrast. Investigate the condition of the organ and pathological changes in it. A few x-rays are taken (direct projection, two lateral, left oblique).
- If a study is planned in the Trendelenburg position, then the patient is transferred to the desired position and pictures are taken.
Next, go to the examination of the stomach. Pictures are taken both in a standing and lying position. If necessary, further examine the intestines.
X-ray examinations are contraindicated for children, but newborns, if there are signs of congenital pathology of the esophagus that require urgent surgery, do an x-ray with contrasting barium.
Study in the position of Trendelenburg
X-ray of the esophagus and stomach in the Trendelenburg position is carried out in terms of a general X-ray contrast study of the gastrointestinal tract and as a separate examination for a hernia of the esophageal opening of the diaphragm.
The study is carried out in the patient’s position on the back, the pelvic end of the table rises by 35-45 degrees relative to the level of the head. In advance, the patient drinks barium suspension, tightly filling her stomach.
The Trendelenburg position is not chosen by chance: the abdominal organs increase pressure on the diaphragm.The abdominal esophagus and part of the stomach slip through the hernial opening into the chest, where they are visualized on an x-ray.
How to do an x-ray of the esophagus with double contrast
For a detailed study of the mucosa, the method of double contrasting using barium and air is used. Barium masses are delayed between the folds of the digestive system. Gas creates enlightenment in an x-ray, against the background of which the relief of the mucosa is clearly looming.
- A probe is placed in the patient's esophagus, a barium suspension is introduced through it.
- Air is pumped through the probe (up to 200 cm³).
- For a more uniform distribution of contrast agents, the patient’s anterior abdominal wall is massaged, antispasmodics are administered.
The method has proven itself in oncology in identifying diseases in the early stages.
What is shown by fluoroscopy of the esophagus and stomach
Using radiographs, you can identify most of the congenital and acquired diseases of the esophagus and stomach.
Anomalies of the esophagus include organ deformities that are easily diagnosed with radiography. In children, abnormal development of the esophagus is a violation of embryogenesis (atresia).
Various diseases lead to anomalies in the adult state:
- acquired esophageal stenosis (cardiospasm, achalasia, strictures),
- organ shortening
- double esophagus
- acquired diverticulums.
On the roentgenogram, diseases having an inflammatory nature (gastritis, esophagitis) are clearly distinguishable. In case of violation of the integrity of the mucous organs on the x-ray visible signs of ulcers and erosion.
Oncological processes, as well as precancerous conditions (cancer, fibroids, Barrett's disease) have their own specific signs.
In the study, you can suspect VRVP - varicose veins.
On the x-ray of the esophagus, various violations of the integrity of the organ (tears, perforations) can be detected.
Not only organic, but functional pathology is detected by fluoroscopy of the esophagus (esophagospasm, corkscrew esophagus).
Indications for radiography
Indications for fluoroscopy of the esophagus are:
- any violation of the act of swallowing,
- discomfort in the chest when eating.
Esophagus diseases are characterized by:
- various dysphagia
- retrosternal pains
Using fluoroscopy and radiography, almost all diseases of the esophagus are diagnosed:
- hiatal hernia
- various abnormalities of the esophagus (shortening, doubling)
- narrowing of the esophagus (cardiospasm, achalasia, cicatricial strictures),
- inflammatory diseases (esophagitis, peptic ulcers),
- malignant and benign tumors.
Together with an x-ray of the esophagus, a study of the stomach is performed, because these organs are connected not only anatomically, but also functionally.
Symptoms are typical for diseases of the stomach:
- epigastric pain
- loss of appetite,
- nausea, often vomiting,
- disorders of the stool.
Indications for radiography of the stomach are:
- acute and chronic gastritis,
- ulcerative lesions
- abnormalities of the stomach.
Contraindications for research
The only serious contraindication for an X-ray examination is pregnancy, especially in the early stages.
However, radiography is not recommended:
- critically ill patients
- patients with thyroid disease,
- people with active tuberculosis,
- patients with decompensated diabetes
For children under 14 years, an x-ray of the esophagus and stomach is also not recommended.
X-ray of the esophagus: what the procedure shows and how to prepare for it
X-ray of the esophagus refers to research methods in the diagnosis of gastrointestinal diseases. It is carried out using special equipment.
The method is based on the effect of the passage of x-rays through tissues to obtain a characteristic image.X-ray examination of the esophagus allows the doctor to make the correct diagnosis.
In what cases is an examination carried out?
A fluoroscopy of the esophagus and stomach is prescribed in the position of trendelenburg by the attending physician. At the same time, a study is done using x-rays and the stomach. This allows you to fully assess the condition of the upper gastrointestinal tract.
It is carried out in the presence of the following patient complaints:
pain in the stomach
- burning sensation and a foreign body behind the sternum,
- difficulty swallowing
- frequent vomiting and nausea,
- frequent spitting up,
- weight loss
- pain behind the sternum while eating.
All these complaints can become the basis for an X-ray examination of the esophagus and stomach. Also, fluoroscopy is performed to assess the degree of narrowing of the esophagus.
Do not resort to this method with a pronounced clinical picture of exacerbation of existing diseases of the gastrointestinal tract. For example, with an exacerbation of the ulcerative process in the stomach.
Do not resort to symptoms of bleeding from the esophagus or stomach. Due to the fact that these conditions require surgical intervention.
And in this case, use other methods that are more appropriate in this situation.
X-ray of the esophagus and stomach: preparation
Radiography of the esophagus should be prepared in a few days. First, avoid taking gas-forming products per day. You should not drink carbonated drinks, nuts or legumes. Since the study is carried out in the morning, the last meal should be carried out no later than 8 o’clock in the evening. Before fluoroscopy of the esophagus and stomach, you should not take food or water.
If the patient has a disease, the preparation is slightly different in this case. A special diet should be followed. Do not eat as sweet, flour. Do not drink carbonated drinks during the day. If required, an enema must be given to eliminate constipation. In some cases, they resort to gastric lavage.
X-ray of the esophagus and stomach: how to do
There are several ways to conduct a study. The traditional method:
- It is carried out in the morning on an empty stomach. The patient is lying on a special table.
- The patient is offered to drink a contrast medium. As it is used barium suspension.
- The patient takes a couple of sips solution with barium. Then the mixture moves along the esophagus, and at this moment translucency is done. When the mixture reaches the sphincter take a picture.
- At the time of the procedure, the patient changes the position of his body. Especially important is the position on the back with a raised pelvis. This allows you to explore other parts of the digestive tract.
This method can diagnose a hernia. In this case, the patient occupies a certain position. Lies with the rise of the pelvis by 45 degrees. Before this, a suspension of barium is drunk accordingly. Due to its position, the mixture penetrates the intestine through the openings of the diaphragm. This leads to a clear outline.
This position allows you to better visualize the diaphragm and hernia in the esophagus. But such a method is strictly prohibited:
- in case of fluid accumulation in the abdominal cavity,
- with a bowel tumor,
- disturbances in the work of the heart and pulmonary system.
In other cases, the method can be carried out without restrictions.
Contrast with two substances
X-ray of the esophagus with contrast is quite effective. It can be carried out using double contrast. In this case, barium and gas are used.
The bottom line is that the barium mixture is drunk using a tube. At the same time, air is swallowed. For the correct and uniform flow of contrast, a massage is performed in the abdomen.
Air, in turn, plays the role of a straightener of folds in the esophagus and stomach.
Additionally use spasmodics. They also affect the muscles, which contributes to the expansion of organs. This method is aimed at a thorough study of the esophagus. With its help, a tumor can be recognized in the early stages.
After this method, constipation and nausea may develop. Drinking plenty of water is also recommended.
What can I learn after research?
Using a procedure such as radiography of the heart with the contrast of the esophagus and stomach, the state of the organs is assessed. Receive data on the degree of thickening of the walls and resizing.
It contains information about the location of organs, the presence or absence of formations. The presence or absence of narrowing in the esophagus is assessed. This method is used to evaluate the effectiveness of treatment.
In this case, the doctor evaluates the images before and after treatment.
The pictures also show the patency of the organs. Evaluate and peristalsis. When fluoroscopy of the esophagus and stomach, the following diseases can be detected:
- Esophageal hernia. In this case, part of the stomach moves into the esophagus. If a hernia is suspected, the Trendelenburg method is performed.
- You can identify diverticula. These are small bags or bulges in the esophagus. Double contrasting helps with this.
- Tumors any localization.
- Inflammation of the mucous membrane of the esophagus and stomach. In this case there will be a thickened wall.
- Mucosal ulcer. In this case, changes in the normal relief of folds in the esophagus are noted.
- Any benign formations.
Using a procedure such as radiography of the esophagus with barium, various diseases can be detected. They will show how effective the x-ray with barium of the esophagus and stomach is from the reviews of patients who underwent it.
What does the doctor see on x-rays?
At the same time, when examining the esophagus, they also examine the stomach. This allows you to comprehensively assess the condition and work of these organs. Pictures are taken in several positions. There is a lateral, direct projection, in the supine position and in Trendelenburg pose.
With a direct projection, the doctor assesses the relief of the entire mucous membrane of the esophagus and the adjacent part of the stomach. It is in this projection that the position and condition of the furrows and folding in the organs are evaluated. Of particular importance is information in a direct projection on the state of transition between the esophagus and the stomach.
With lateral projection, the degree of displacement of organs is assessed. That is, in this case, it is clearly visible whether the patient has neoplasms. In this case, the tumor may be adjacent organs. Such a phenomenon will be visible in the pictures, as a change in the localization and displacement of the organ. In the lateral projection, it is also possible to assess the condition of the esophageal-gastric sphincter and determine reflux.
The supine position allows you to assess the condition of the gastric mucosa. In the picture, the doctor clearly sees precisely the lesser curvature of the stomach. Assessment of the condition of folds and furrows.
Trendelenburg posture allows you to assess the condition of the esophagus opening in the diaphragm. With the help of this position of the body, a hernia is revealed.
X-ray of the esophagus and stomach with barium (contrasting): how is radiography done
X-ray in the diagnosis of gastrointestinal diseases takes a leading place. X-ray of the esophagus and stomach is a non-invasive, fast and highly informative examination method.
One of the varieties of x-ray diagnostics is fluoroscopy: it allows you to examine the organs of the digestive tract in real time in dynamics on the screen of the x-ray apparatus and record diagnostically significant moments on the film.
The basis of the study is the property of x-ray rays to penetrate deep into biological objects, causing biophysical changes that can be recorded on the screen or film.
The negative influence of rays is due to the fact that acting on biological objects, they cause the formation of ions, which are chemically much more active than neutral chemicals.
In high concentrations, ions are able to act on the cell nucleus, transforming its genetic material and causing cell death.
However, in modern x-ray units, the radiation dose is so small that it cannot harm the patient.
Table of contents
- X-ray of the esophagus and stomach with barium (contrasting): how is radiography done
- In which cases do an x-ray of the esophagus and stomach
- Types of fluoroscopy of the esophagus
- Panoramic radiography of the esophagus and stomach
- X-ray of the esophagus and stomach with barium
- Esophagus x-ray with double contrast
- How do x-rays of the esophagus and stomach in the Trendelenburg position
- Preparation for the procedure
- How is fluoroscopy of the esophagus and stomach
- Study in the position of Trendelenburg
- How to do an x-ray of the esophagus with double contrast
- What is shown by fluoroscopy of the esophagus and stomach
- What does the doctor evaluate on x-rays
- Indications for radiography
- Contraindications for research
X-ray of the esophagus: preparation, procedure and interpretation of the results of the examination
Pain in the epigastric region, a feeling of heaviness after eating food, belching and the appearance of an unpleasant aftertaste in the mouth are not always associated exclusively with lesions of the stomach. Very often the cause of the appearance of unpleasant symptoms is the esophagus - the "conductor" between the oral cavity and the stomach.
Sometimes his condition becomes a cause for numerous complaints of patients about severe discomfort and pain, especially after eating or drinking.
In this case, you can’t do without a visit to the doctor - only an experienced specialist can make an accurate diagnosis and draw up a scheme for the correct treatment of the disease.
Since many diseases of the gastrointestinal tract are accompanied by similar symptoms, special examinations are indispensable. One of them is a radiography of the esophagus.
In what situations is the study assigned
X-ray of the esophagus - an effective method for studying the condition of the esophagus using a contrast medium
X-ray of the esophagus is the most gentle procedure, which is often prescribed as an additional research method or as the only possible option in cases where fibrogastroscopy or endoscopy is not possible due to physical obstruction or because the patient is panicky afraid to “swallow” Olive gastroscope or because of nerve spasms it is impossible to insert an endoscope probe.
In addition to detecting a variety of diseases, conditions and structural abnormalities, an x-ray of this important organ will help determine the location and location of various foreign bodies that can enter the esophagus when swallowing, from food, or in another way.
Very often, various bones of fish and animals, as well as fruit bones, coins, are found on x-rays, while small children have small figures, details of designers and components of various toys. But sometimes an x-ray can show the presence of more dangerous objects - needles, knitting needles, pins, invisible and hairpins, even knives and forks.
In these cases, it is the timely detection of dangerous objects in the esophagus that allows you to save a person’s life by quickly performing an operation.
An x-ray of the esophagus is prescribed for any complaints of pain and severe discomfort in this area, as well as in cases where the study is not possible in other ways.
If the patient complains of frequent or constant heartburn, a feeling of throwing unpleasant acidic and burning stomach contents into the oral cavity, pain, a feeling of heaviness, cramping when swallowing solid food, or acute pain when ordinary water passes through the esophagus, he has a direct path to a gastroenterologist,who will prescribe all the necessary tests and send to the x-ray of the stomach and esophagus. This study may be the main one, but it is more often used as an auxiliary one due to the fact that it has less information content compared to endoscopy and other modern, advanced methods of diagnosing diseases.
Indications and contraindications for x-rays of the stomach and esophagus
X-ray examination is a common diagnostic method. An x-ray of the stomach and esophagus is indicated in almost any complaints related to these organs. These complaints can be pains of a certain localization, sour belching, heartburn or violation of swallowing and pain when swallowing. However, it should be borne in mind that an X-ray study carries a certain amount of radiation, therefore, this study should not be in vain if necessary.
Indications and contraindications for x-ray examination are more accurately determined by the doctor.
In order for the diagnosis to be accurate, the doctor needs to report all the disturbing symptoms and talk about how the disease developed. Thus, the appropriateness of the X-ray examination can be established and the search for the radiologist who conducts the study is facilitated.
Indications for x-ray of the esophagus
X-ray of the esophagus is indicated for violation of swallowing and any discomfort in the esophagus during meals. Damage to the esophagus causes symptoms that are usually difficult to confuse with lesions of any other organs. However, it must be remembered that not every pain behind the sternum is cardiac. It can often be confused with peptic and inflammatory diseases of the esophagus and stomach.
Esophageal diseases are characterized by the following symptoms:
- mid-chest pain
- belching food
- a feeling of heaviness in the upper stomach,
- difficulty swallowing.
Using the x-ray, the following diseases of the esophagus are diagnosed:
- diverticulum (bag protrusion),
- hernia in the esophageal opening of the diaphragm,
- shortening, doubling and other abnormalities of the esophagus,
- narrowing (stenosisesophagus
- foreign bodies
- inflammatory diseases of the esophagus (esophagitis),
- tumor formations.
Indications for an X-ray of the stomach
X-ray of the stomach is indicated for various diseases of this organ. An X-ray of the stomach is usually performed in conjunction with other diagnostic procedures, including ultrasound or endoscopic examination (endoscopy) Depending on whether the diagnosis is accurately established using previous studies, an X-ray examination is performed to establish or refine the diagnosis.
X-ray of the stomach is indicated for the diagnosis of the following diseases:
- acute and chronic gastritis,
- stomach ulcer
- tumors of the stomach
- malformations and anomalies in the structure of this organ,
- congenital or acquired narrowing of various parts of the stomach.
X-ray of the stomach is carried out using a contrast mass. It fills not only the stomach, but also the esophagus, small intestine. Thus, during the X-ray of the stomach, you can examine almost the entire gastrointestinal tract, depending on the symptoms. The universality of this approach is an advantage of the X-ray diagnostic method.
Contraindications to x-ray examination of the stomach and esophagus
X-ray examination is a powerful diagnostic method, but in some cases it is contraindicated. Firstly, this is due to the duration of the x-ray. In some acute conditions, the patient requires urgent care, while it takes about several hours to examine the stomach and esophagus with contrast. Secondly, an X-ray examination is not recommended in cases where the patient’s body is too susceptible and may suffer from x-ray radiation. This applies to pregnant women, children, patients in serious condition.
Thus, an x-ray of the stomach is contraindicated in the following cases:
It's no secret that x-ray radiation can harm the human body. The first researchers of x-rays suffered from manifestations of radiation sickness and more than a century ago they suggested that it was precisely x-rays that could be their cause. The harm from x-rays is due to the ionization of molecules and atoms in the human body. However, it is worth noting that this effect is manifested only with a large dose of radiation, which cannot be obtained in a medical x-ray room.
The following human organs are most sensitive to x-rays:
- Bone marrow,
- The lymph nodes,
- endocrine glands.
Radiation sickness has the following manifestations:
- general weakness
- nausea and vomiting,
- skin redness
- temperature rise,
- changes in blood composition (decrease in the number of white and red blood cells).
X-ray dose of the stomach and esophagus with contrast
It is proved that x-ray radiation can adversely affect the human body. In this regard, it became necessary to create norms and standards for X-ray examination. X-rays are measured by certain devices. X-ray unit is milliSievert (mSv) It is believed that during the year the total radiation background to which a person is exposed from the surrounding nature is 2 mSv.
The radiation doses to which a person is exposed during the study of the stomach and esophagus are much smaller.With digital radiography, the radiation dose is 0.1 mSv, and with film - 0.8 mSv. Thus, a digital x-ray study creates a radiation dose that is 20 times less than the annual radiation background. Outdated method of studying the stomach in real time (fluoroscopy) creates an exposure of 3.5 mSv. Due to the high degree of exposure, such a technique has recently been abandoned.
How often can I do an x-ray of the stomach and esophagus?
It is very important to know the doses of x-ray radiation to both the doctor and the patient, since they have a cumulative effect. The medical record of each patient stores information about x-ray studies. Their accounting is carried out in order to comply with annual standards established by the health system. Exceeding these standards is considered unsafe, but in exceptional cases they can be neglected.
According to the regulations of the X-ray examination, it must be carried out in such a way as not to exceed a dose of 1 mSv during the year. This means that a digital x-ray of the stomach and esophagus can be performed 10 times during the year, and film x-ray - only once. In addition, you need to remember that an X-ray may be needed to examine other parts of the body, such as the bones of the hands.
An X-ray examination of the stomach and esophagus may actually be needed several times during the year. This applies to diseases such as chronic gastritis or gastric ulcer. In chronic diseases, dynamic monitoring of the state of the gastric mucosa is required. This decisively affects the tactics of treatment, the choice of drugs. Due to the fact that digital x-ray creates a small dose of radiation, it can be safely repeated several times during the year.
X-ray of the stomach and esophagus
An x-ray of the stomach and esophagus is one of the main procedures for the diagnosis of diseases of these organs. This study can be performed both in special medical institutions and in private centers. When the patient is familiar with the principles of x-ray research, he tolerates it more easily, which also helps the doctor and favorably affects the results of the study.
To get a referral for an X-ray examination of the stomach or esophagus, you must consult a family doctor.
Depending on the severity of the patient’s condition, the family doctor recommends an X-ray examination of the stomach and esophagus. A qualitative study of these organs is carried out in special gastroenterological hospitals. In such centers, medical personnel specialize specifically in research of this kind.
The procedure for x-ray examination of the esophagus and stomach takes quite a long time. It is required in order for the contrast medium to enter the stomach. During this time, several shots are taken in various projections. This is done in order to objectively assess the condition of the wall of the stomach and esophagus from various sides. The X-ray examination procedure is painless and does not cause discomfort.
Where is an x-ray of the stomach and esophagus performed?
An x-ray of the stomach and esophagus is performed in special rooms for x-ray diagnostics. They have a high level of protection against radiation. Protection in X-ray cabinets involves the use of dense screens along walls, windows, floors and ceilings that absorb the radiation background. The X-ray room in the medical facility can be recognized by the thick iron door and the warning lamp “Do not enter!”.
The office for x-ray diagnostics is well known to many people, since almost all of them performed x-rays during their lives.The X-ray room does not contain dangerous objects or apparatuses, however, many are worried when carrying out this research method. An X-ray study is not possible without an X-ray unit, which is a source of radiation.
The equipment for the X-ray room is made up of the following items:
- X-ray unit
- X-ray examination table,
- X-ray receiver
- computer for remote control and processing of the received images,
- safety vests and screens for the patient and medical staff,
- contrast agents of various compositions,
- first aid kit and first aid supplies.
Which doctor does an x-ray of the stomach and esophagus?
It should be borne in mind that the radiologist does not establish a final diagnosis. His tasks include a description of the objective picture in an x-ray. The diagnosis is made by the attending physician, taking into account all the available diagnostic data. Naturally, the conclusion of the radiologist is the most important and essential of them. The radiologist is also not involved in the treatment of diseases of the stomach and esophagus. Treatment of diseases of the stomach and esophagus may be prescribed by a family doctor (therapist) or a gastroenterologist.
What is barium suspension? How to drink barium mass before an x-ray of the stomach and esophagus?
An X-ray of the stomach and esophagus is performed using a contrast agent. Barium sulfate mixed in water at various concentrations is used as a contrast medium. Concentration depends on the goals of the X-ray examination and the intended diagnosis. Barium suspension is drunk like an ordinary liquid. It completely fills the entire lumen of the gastrointestinal tract and facilitates x-ray examination due to the fact that barium has a high density and delays x-rays.
Barium suspension has a neutral taste, white color and high viscosity. She has no smell. Flavoring agents may be present in the barium mass, which slightly improve the taste of the contrast medium. However, despite this, barium lime seems unpleasant to many. To facilitate the intake of barium suspension, doctors recommend replacing it in your imagination with yogurt or another dairy product.
The correct use of barium mass is of great importance. Barium mass is drunk in an amount of 350 - 500 ml, which corresponds to two glasses or cups. At first they drink a denser, and then - a diluted mass. This greatly affects the speed of filling the esophagus and stomach and increases the time available for a series of x-rays. Barium mass is drunk in small sips. All these recommendations must be observed in order for it to move at a moderate speed and evenly fill the esophagus and stomach.
What is the sequence of actions when performing an x-ray of the stomach and esophagus?
An x-ray of the esophagus and stomach is carried out in a certain sequence. The study itself takes about 1.5 - 2 hours, so it is very important to follow all the rules and recommendations. The study is usually carried out in the morning. Before starting the study, the patient should undress to the waist and put on a bathrobe.All metal objects, including jewelry, belt buckles, telephones, keys, prostheses, must be removed during the X-ray examination. First, the esophagus is examined radiologically, and after filling the stomach with barium mass, they go on to study the stomach.
X-ray examination of the esophagus consists of the following steps:
- Initially, a normal panoramic chest x-ray is performed while standing,
- the patient drinks barium mass, the first portion of which is thicker than subsequent portions,
- perform x-rays of the chest cavity in various projections in a standing position (straight, two side and oblique left projections),
- the patient is fixed to the X-ray table and transferred to the Trendelenburg position, which is 35 degrees different from the horizontal (head below legs),
- in this position, the patient also drinks a little barium suspension to assess the function of the lower esophageal sphincter with a few x-rays.
After the study, you should eat to satisfy your hunger. The patient should not eat food for at least 12 hours before the study, so after it should be a good meal. It must be borne in mind that sometimes due to the use of a contrasting mass, digestive disorders are observed, so you should be calm about bleaching stools or bloating.
X-ray technique of the stomach with double contrast
X-rays of the stomach are almost always carried out using a contrast medium. Barium suspension completely fills the lumen of the stomach. However, to study the relief of the mucous membrane, double contrasting is used when, in addition to the barium mass, gas-forming substances are used.
With double contrasting, barium residues linger between the folds of the gastric mucosa. Against the background of gas, which creates a zone of enlightenment, the relief of the gastric mucosa becomes accessible for examination in an x-ray. The double contrast method is used for suspected tumor formation of the gastric mucosa. Among gas-forming substances, the simplest composition is a mixture of citric acid and soda in a 1: 1 ratio.
With double contrast, 6 pictures are taken in the following sequence:
- X-ray in supine position
- lying on your back
- in the right oblique projection,
- in the left oblique projection,
- standing in direct projection
- in the left side projection.
X-ray of the stomach and esophagus in the Trendelenburg position
An X-ray of the stomach in the Trendelenburg position is a special variety intended for the diagnosis of hiatal hernia.In this position, the patient lies completely on the X-ray table, and the foot end of the body is raised by 35 - 45 degrees relative to the head. In the rest, the research methodology does not differ from ordinary contrast research. The patient drinks up to 500 ml of contrasting barium suspension in advance, and then a series of x-rays is taken in the aforementioned position.
The position of Trendelenburg is advantageous in that, under the influence of gravity, the organs of the abdominal cavity are shifted to the diaphragm, that is, increased pressure is artificially created on this muscle wall. Under such conditions, its insufficiency may occur, that is, part of the stomach will penetrate through the opening of the esophagus into the chest cavity. The contrast agent, having completely filled the stomach, will indicate a hernia on an x-ray. If the x-ray was performed in an upright position, the contents of the hernial sac are lowered into the abdominal cavity and the hernia may not be detected.
Trendelenburg position is often used in surgery for pelvic surgery. It was in surgery that this position was first applied. If a person feels weak and fainting, then he should be placed in such a position, since it increases the flow of blood to the brain and improves his nutrition.
What side effects can be observed after an X-ray examination of the stomach and esophagus?
During an X-ray examination, care must be taken to ensure that the contrast agent does not enter the respiratory tract. Barium mass can penetrate there in violation of the swallowing reflex. Due to its high density, barium mass settles in the lungs and is very difficult to excrete, so this complication should be very carefully avoided. Contrast barium mass should be drunk slowly and carefully.
After an X-ray examination of the stomach and esophagus, there are usually no side effects. After this procedure, it is recommended to increase the amount of fluid used. This will help to quickly remove excess barium mass from the body. Within a few days, the stool may be discolored. Barium retention can lead to constipation, in which case the patient is recommended to take laxatives.
Among the side effects after using a contrast medium, it is sometimes found:
- weakening of peristalsis.
Diet before x-ray of the stomach and esophagus
X-ray examination requires different preparation in people with different digestion. The more pronounced violations of the stomach and intestines, the more carefully you need to approach the preparation. For people with normal digestion, a diet for 2 to 3 days is recommended, and for those who suffer from constipation or flatulence, from 3 to 5 days. A diet before an x-ray of the stomach and esophagus excludes foods that increase gas formation in the intestines and stomach.
Doctors recommend limiting the use of the following gas-forming products before an X-ray of the stomach and esophagus:
- bean (beans, peas),
- vegetables (onions, cabbage),
- cakes, sweet flour products,
- yeast dough,
- pork, beef, lamb,
- carbonated drinks,
What can I eat during a diet before an x-ray of the stomach?
Diet before x-ray eliminates many foods that have a gas-forming effect. On the other hand, the question arises of what can be eaten during preparation for an X-ray examination. Fortunately, the diet of modern man allows you to replace some foods without reducing calories and overall nutritional value.
Before an X-ray of the stomach and esophagus, the following products are allowed for use:
- cereal cereals in the water,
- chicken bouillon,
- steamed chicken meat
- Fish and seafood,
- hard cheese.
How many hours can I eat before an x-ray of the stomach and esophagus?
One of the main requirements for a stomach x-ray is to eat at least 9 to 12 hours before the study. It is explained by the fact that the esophagus and stomach should be empty before the study. Even a small amount of contents in the stomach can interfere with the staining of the mucous membrane with a contrast agent. In addition, eating during this period can lead to the formation of intestinal gases, bloating, and changes in peristalsis.
Due to the fact that an X-ray study requires fasting for half a day, this study is carried out in the morning. As an exception, a few hours before the study, before leaving the house you can drink several glasses of plain still water. It quickly passes through the stomach and does not linger in it, but for some time it removes the feeling of hunger. Breakfast is recommended immediately after an X-ray examination, since prolonged fasting has a negative effect on the health of the gastrointestinal tract.
Can medicines be used before an x-ray of the stomach and esophagus?
In preparation for an X-ray, ideally, the gastrointestinal tract is cleansed of various toxins. Some help in this can be provided by drugs, the role of which is to absorb various intestinal toxins. It should be borne in mind that their intake should also be stopped 12 hours before the study with meals.
A few days before an X-ray of the stomach and esophagus, you can take one of the following drugs:
- Activated carbon,
- Espumisan and some other medicines.
Is it possible to smoke and take alcohol before an x-ray of the stomach and esophagus?
Smoking and alcohol are risk factors for many diseases, including diseases of the gastrointestinal tract. Every smoked cigarette and every milliliter of alcohol has an effect on the work of the stomach.Before carrying out an x-ray of the stomach and esophagus, smoking and drinking alcohol is strictly prohibited, since the functional activity of the stomach changes greatly.
Scientists have proven that stomach ulcers are about twice as likely to develop in smokers than non-smokers. After smoking a cigarette, the components of tobacco smoke are rapidly absorbed into the bloodstream and affect the functioning of the central nervous system. Because of this, a malfunction of the stomach occurs, gastric juice is produced in increased quantities and irritates the gastric mucosa.
After smoking just one cigarette, the following changes occur in the stomach:
- weakening of the motility of the stomach,
- decrease in the tone of the gastric wall,
- an increase in the amount of gastric juice and its acidity.