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Upper Gastrointestinal Exam (UGI)

What is an upper gastrointestinal exam (UGI)?
An upper GI exam is an x-ray examination of the esophagus, stomach and first part of the small intestine (duodenum). Images are produced using a special form of x-ray called fluoroscopy and an orally ingested contrast material such as barium.

Fluoroscopy allows a radiologist to view internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and small intestine. In addition to barium, some patients are also asked to drink baking soda crystals to further improve the images. This procedure is called a double-contrast upper GI.

Alternative contrast materials may be used if a patient has recently undergone surgery on the GI tract, or has allergies to contrast materials. The radiologist will determine which type of contrast material will be used.

What are some common uses of the procedure?
An upper GI examination helps evaluate digestive function and can detect:
• Ulcers
• Tumors
• Inflammation of the esophagus, stomach and duodenum
• Hiatal hernias
• Scarring
• Blockages
• Abnormalities of the muscular wall of GI tract
An upper GI examination can also help diagnose the cause of symptoms including:
• Difficulty swallowing
• Chest and abdominal pain
• Reflux
• Unexplained vomiting
• Severe indigestion
• Blood in the stool

How should I prepare for my exam?
You should inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials. Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant.

To ensure the best possible image outcomes, your stomach must be empty of food. Therefore, your doctor will likely ask you not to eat or drink anything and to refrain from chewing gum after midnight on the day of the examination.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eyeglasses and any metal objects or clothing that might interfere with the x-ray images.

What can I expect during the exam?
A radiologic technologist and a radiologist guide the patient through the upper GI series. As the patient drinks the liquid barium, the radiologist will watch the barium travel through the patient’s digestive tract on a fluoroscope, a device that projects radiographic images onto a monitor. Once the upper GI tract is adequately coated with the barium, still x-ray images will be taken and stored for further review. The examination is typically completed within 20 minutes.

What can I expect after the exam?

After the exam, you can resume a regular diet and take oral medications unless instructed otherwise by your doctor. The barium may color your stools gray or white for 48 to 72 hours after the procedure. Sometimes the barium can cause temporary constipation, which is usually treated by an over-the-counter laxative. Drinking large quantities of fluids for several days following the exam can also help.

A radiologist will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with Sometimes a follow-up exam is needed, when a suspicious or questionable finding requires clarification with additional views or a special imaging technique.