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Pediatric Upper Gastrointestinal Exam (Pediatric UGI)

What is an Upper GI (gastrointestinal) X-ray?

An upper GI (gastrointestinal) X-ray is a safe procedure that uses radiation to take a picture of the upper GI tract.  It’s also called an upper GI series.

An upper GI X-ray is used to help find the cause of problems such as swallowing difficulties, unexplained vomiting, nausea, abdominal discomfort, and severe indigestion.  It can detect signs of problems such as ulcers, gastric reflux, hiatal hernia, or blockages or narrowing of the upper GI tract.

During the examination, a child drinks a thick liquid (barium sulfate), and images are recorded on a computer.  The images taken include the esophagus, stomach, and the beginning of the small intestine (called the duodenum). 

A radiologist uses a technique called fluoroscopy to do an upper GI series.  While your child drinks, an X-ray video of the barium moving through the digestive system is watched on a screen and recorded, and a series of still X-ray films is taken.

Preparation

An upper GI must be done when the stomach is empty.  Your child shouldn’t have anything to eat or drink for a certain number of hours before the procedure, depending on your child’s age.  Your child will be asked to remove clothing and jewelry and change into a hospital gown because buttons, zippers, clasps, or jewelry might interfere with the image.

It’s also important to inform the technician or the doctor if your child had an X-ray exam using barium contrast material in the days prior to the upper GI series, or if your child took antidiarrheal or stomach-upset medicine containing bismuth subsalicylate, as this can interfere with the image.  Also, make sure to tell the technician of any allergies your child has, as the barium sulfate may contain soy derivatives.

Feel free to bring a special toy, blanket, book or other belonging to provide comfort during the exam.  Also consider bringing a snack or treat that you may give your child after the exam.

You can help your child prepare for an upper GI series by explaining the test in simple terms before the procedure.  It may help to explain that getting an upper GI X-ray is like being in a video and to reassure your child that you’ll be right there for support.

During the Exam

The procedure will take 15-20 minutes, although actual exposure to radiation is usually only a couple of minutes or less.

Your child will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling or wall.  Parents usually are able to accompany their child to provide reassurance. 

The technician will position your child on the table and an X-ray will be taken of the stomach with nothing in it.  The radiologist will perform the test as your child drinks barium sulfate.  This liquid looks like a light-colored milkshake and is often flavored for toddlers and young kids.

The radiologist or technician may move your child on the table to help ensure that the barium coats the esophagus and stomach.  As your child swallows and the barium moves through the GI tract, its path can be seen on a monitor.  At some points, still images will be taken, during which older kids may be asked to hold their breath and stay still for 2-3 seconds; infants may require gentle restraint.  Keeping still is important to prevent blurring of the X-ray images.

What to Expect

The barium sulfate that your child drinks may have a chalky taste, but it’s important that the full amount requested by the doctor be taken.

The positions required for the upper GI study may feel uncomfortable, but they don’t need to be held for long.  Babies often cry, especially if they’re restrained, but this won’t interfere with the procedure.

After the Exam

Barium sulfate makes stools (feces) light-colored and hard for a few days after the procedure, so giving your child extra fluids can be helpful.